Angelica Elizabeth Anderson, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT60329481 Issued in WA

Practice address

1010 S 336TH St
Suite 112
Federal Way, WA 98003-6385

Phone

(253) 661-0041

Fax

(253) 661-0772

NPI assigned

Mar 4, 2013

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Angelica Elizabeth Flynn Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1362355200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1465862400000",
    "number": "1811238645",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1010 S 336TH ST",
            "address_2": "SUITE 112",
            "city": "FEDERAL WAY",
            "state": "WA",
            "postal_code": "980036385",
            "telephone_number": "253-661-0041",
            "fax_number": "253-661-0772"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1010 S 336TH ST",
            "address_2": "SUITE 112",
            "city": "FEDERAL WAY",
            "state": "WA",
            "postal_code": "980036385",
            "telephone_number": "253-661-0041",
            "fax_number": "253-661-0772"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "ANGELICA",
        "middle_name": "ELIZABETH",
        "credential": "PT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-03-04",
        "last_updated": "2016-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WA",
            "license": "PT60329481",
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "AZ",
            "license": "10804",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "10804",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ANGELICA",
            "last_name": "FLYNN",
            "middle_name": "ELIZABETH",
            "credential": "PT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Amrit Mattu DDS PLLC
• An Pham, OD, LLC
• Bo-Mi An, PHARMD
• David Anaya
• Amanda Elizabeth Anderson, LPN
• Barbara Anne Anderson, REGISTERED NURSE
• Davaughn Anderson
• Glenn Douglas Anderson
• Haley Anderson, LMP
• Kyle Anderson, LMFT

• Physical Therapist in Federal Way, WA
• Providers in Federal Way, WA by specialty
• Physical Therapist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.