NPIMap

Organization Active NPI

Harbor Physical Therapy and Wellness Clinic

  • Physical Therapist
  • Freeland, WA
National Provider Identifier
1881977148
Registry record updated Sep 23, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
603025614 Issued in WA
Legal business name
HARBOR PHYSICAL THERAPY AND WELLNESS CLINIC
Practice address
5508 Harbor Ave
Freeland, WA 98249
Phone
(360) 331-3969
Fax
(360) 331-0152
NPI assigned
Sep 23, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 23, 2011

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

Authorized official

Name
Michael James Goodman, PTNPI 1467450007
Title
Owner, Physical Therapist
Phone
(360) 331-3969

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225100000X 603025614 WA Primary

Addresses

Primary practice location

5508 Harbor Ave
Freeland, WA 98249

Mailing address

PO Box 958
Freeland, WA 98249-0958
Phone (360) 331-3969

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1316736000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1316736000000",
    "number": "1881977148",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 958",
            "city": "FREELAND",
            "state": "WA",
            "postal_code": "982490958",
            "telephone_number": "360-331-3969",
            "fax_number": "360-331-0152"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5508 HARBOR AVE",
            "city": "FREELAND",
            "state": "WA",
            "postal_code": "98249",
            "telephone_number": "360-331-3969",
            "fax_number": "360-331-0152"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HARBOR PHYSICAL THERAPY AND WELLNESS CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-09-23",
        "last_updated": "2011-09-23",
        "status": "A",
        "authorized_official_last_name": "GOODMAN",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "JAMES",
        "authorized_official_title_or_position": "OWNER, PHYSICAL THERAPIST",
        "authorized_official_telephone_number": "360-331-3969",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": "WA",
            "license": "603025614",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Freeland, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2011; 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.