Active NPI
Ellen Sumner Hornbeak, PT, DPT
- Physical Therapist
- Longview, WA
National Provider Identifier
1891291910
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT60903963
- Practice address
- 200 Triangle Shopping Ctr Ste 270
Longview, WA 98632 - Phone
- (360) 501-3750
- Fax
- (360) 501-3755
- NPI assigned
- Apr 5, 2018
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 62610 | OR | |
| Physical Therapist | 225100000X | PT60903963 | WA | Primary |
Addresses
Primary practice location
200 Triangle Shopping Ctr Ste 270
Longview, WA 98632
Mailing address
4712 NE 13TH CT
Vancouver, WA 98663-6309
Phone (281) 620-7869
Other practice location 1
319 NE Russet St
Portland, OR 97211-2815
Phone (503) 289-5571
Other practice location 2
4805 NE Glisan St
Portland, OR 97213-2933
Phone (503) 215-5945
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 |
|---|---|---|---|
| 62610 | OR | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1522886400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1542153600000",
"number": "1891291910",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4712 NE 13TH CT",
"city": "VANCOUVER",
"state": "WA",
"postal_code": "986636309",
"telephone_number": "281-620-7869"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "200 TRIANGLE SHOPPING CTR STE 270",
"city": "LONGVIEW",
"state": "WA",
"postal_code": "98632",
"telephone_number": "360-501-3750",
"fax_number": "360-501-3755"
}
],
"practiceLocations": [
{
"address_1": "319 NE Russet St",
"address_purpose": "LOCATION",
"city": "Portland",
"state": "OR",
"postal_code": "972112815",
"country_code": "US",
"telephone_number": "503-289-5571",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "4805 NE Glisan St",
"address_purpose": "LOCATION",
"city": "Portland",
"state": "OR",
"postal_code": "972132933",
"country_code": "US",
"telephone_number": "503-215-5945",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "HORNBEAK",
"first_name": "ELLEN",
"middle_name": "SUMNER",
"credential": "PT, DPT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-04-05",
"last_updated": "2018-11-14",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "OR",
"license": "62610",
"primary": false
},
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "WA",
"license": "PT60903963",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Longview, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.