Active NPI
Jonathan E Erickson, PT
- Physical Therapist
- Bonney Lake, WA
National Provider Identifier
1881772812
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT8411
- Practice address
- 21525 Hwy 410 E
Bonney Lake, WA 98391-4101 - Phone
- (253) 826-8520
- Fax
- (253) 826-8522
- NPI assigned
- Nov 1, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | PT8411 | WA | Primary |
Addresses
Primary practice location
21525 Hwy 410 E
Bonney Lake, WA 98391-4101
Mailing address
21525 Hwy 410 E Ste B
Bonney Lake, WA 98391-4101
Phone (253) 826-8520
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PT8411 | WA | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Outpatient Physical Therapy & Sports Rehabilitation Inc PC | Physical Therapist | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Physical Therapist
- Maple Valley, WA
- NPI 1730394420
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1162339200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1242172800000",
"number": "1881772812",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "21525 HWY 410 E STE B",
"city": "BONNEY LAKE",
"state": "WA",
"postal_code": "983914101",
"telephone_number": "253-826-8520",
"fax_number": "253-826-8522"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "21525 HWY 410 E",
"city": "BONNEY LAKE",
"state": "WA",
"postal_code": "983914101",
"telephone_number": "253-826-8520",
"fax_number": "253-826-8522"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ERICKSON",
"first_name": "JONATHAN",
"middle_name": "E",
"name_prefix": "Mr.",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-11-01",
"last_updated": "2009-05-13",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "WA",
"license": "PT8411",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bonney Lake, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.