Individual provider Active NPI

Shari J. Brennecke, MPT

  • Physical Therapist
  • Kirkland, WA
National Provider Identifier
1831187814
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT00008078 Issued in WA
Practice address
12910 Totem Lake Blvd NE
Suite 101
Kirkland, WA 98034-2954
Phone
(425) 814-5080
NPI assigned
Oct 12, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT00008078 WA Primary

Addresses

Primary practice location

12910 Totem Lake Blvd NE
Suite 101
Kirkland, WA 98034-2954

Mailing address

12910 Totem Lake Blvd NE
Suite 101
Kirkland, WA 98034-2954
Phone (425) 814-5080

Other identifiers 1

IdentifierTypeStateIssuer
8379992MedicaidWA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040407000419 WA Practitioner - Physical Therapist in Private Practice 6709879521 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Pacmed ClinicsGroup PAC ID 2466350657, 211 clinicians

Practice addresses (Care Compare)

1909 214TH St SE
Suite 300
Bothell, WA 98021-4418
Phone (425) 412-7200

220 15TH Ave SE
Puyallup, WA 98372-3797
Phone (253) 435-3400

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Pacmed Clinics CurrentSince Oct 18, 2008 Accepting new patients
Pacmed Clinics CurrentSince Oct 18, 2008 Accepting new patients
Pacmed Clinics Current Accepting new patients

Locations

1909 214th St SE
Ste 300
Bothell, WA 98021
Phone (425) 412-6335

12910 Totem Lake Blvd NE
Ste 101
Kirkland, WA 98034
Phone (425) 814-5000

220 15th Ave SE
Puyallup, WA 98372
Phone (253) 435-3400

601 S Carr Rd
Ste 100
Renton, WA 98055
Phone (425) 227-3700

1101 Madison St
Ste 301
Seattle, WA 98104
Phone (206) 505-1101

1200 12th Ave S
Seattle, WA 98144
Phone (206) 326-2400

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1129075200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1831187814",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12910 TOTEM LAKE BLVD NE",
            "address_2": "SUITE 101",
            "city": "KIRKLAND",
            "state": "WA",
            "postal_code": "980342954",
            "telephone_number": "425-814-5080"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12910 TOTEM LAKE BLVD NE",
            "address_2": "SUITE 101",
            "city": "KIRKLAND",
            "state": "WA",
            "postal_code": "980342954",
            "telephone_number": "425-814-5080"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRENNECKE",
        "first_name": "SHARI",
        "middle_name": "J.",
        "credential": "MPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-10-12",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WA",
            "license": "PT00008078",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8379992",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kirkland, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.