NPIMap

Organization Active NPI

Coast Spine and Sports Medicine PLLC

Doing business as Coast Injury Medicine

  • Physical Medicine & Rehabilitation Physician
  • Everett, WA
National Provider Identifier
1902518517
Registry record updated Jul 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
Legal business name
COAST SPINE AND SPORTS MEDICINE PLLC
Doing business as
Coast Injury Medicine
Practice address
15 SW Everett Mall Way Ste I
Everett, WA 98204-2715
Phone
(253) 648-1853
Fax
(425) 800-9756
NPI assigned
Dec 15, 2022
Last updated
Jul 14, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 14, 2025

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

Authorized official

Name
Sandy Clemens
Title
Access Manager
Phone
(253) 648-1853

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208100000X Primary

Addresses

Primary practice location

15 SW Everett Mall Way Ste I
Everett, WA 98204-2715

Mailing address

8012 112TH Street CT E Ste 120
Puyallup, WA 98373-7856
Phone (253) 648-1853

Other practice location 1

1819 100th Pl SE Ste A
Everett, WA 98208-3864
Phone (425) 386-0203

Other names 1

  • Coast Injury Medicine Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Coast Injury Medicine6 organizations share this tax ID, including this one

Other organizations with this tax ID 5

Organizations that report the same tax identification number in the National Provider Directory.

Locations

15 SW Everett Mall Way
Ste I
Everett, WA 98204
Phone (253) 648-1853

1701 41st St
Ste A1
Everett, WA 98201

1819 100th Pl SE
Ste A
Everett, WA 98208
Phone (425) 386-0203

NPI Registry JSON

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

{
    "created_epoch": "1671062400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1752451200000",
    "number": "1902518517",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8012 112TH STREET CT E STE 120",
            "city": "PUYALLUP",
            "state": "WA",
            "postal_code": "983737856",
            "telephone_number": "253-648-1853",
            "fax_number": "425-800-9756"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15 SW EVERETT MALL WAY STE I",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "982042715",
            "telephone_number": "253-648-1853",
            "fax_number": "425-800-9756"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1819 100th Pl SE Ste A",
            "address_purpose": "LOCATION",
            "city": "Everett",
            "state": "WA",
            "postal_code": "982083864",
            "country_code": "US",
            "telephone_number": "425-386-0203",
            "fax_number": "425-800-9756",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "COAST SPINE AND SPORTS MEDICINE PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-12-15",
        "last_updated": "2025-07-14",
        "certification_date": "2025-07-14",
        "status": "A",
        "authorized_official_last_name": "CLEMENS",
        "authorized_official_first_name": "SANDY",
        "authorized_official_title_or_position": "ACCESS MANAGER",
        "authorized_official_telephone_number": "253-648-1853"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Medicine & Rehabilitation",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Coast Injury Medicine",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Everett, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2025; 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.