Active NPI
Wolfgang Brolley, PT
- Physical Therapist
- Seattle, WA
National Provider Identifier
1912009325
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT4092
- Practice address
- 7900 E Green Lake Dr N
Seattle, WA 98103-4800 - Phone
- (206) 985-2236
- Fax
- (206) 985-2248
- NPI assigned
- Sep 5, 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 | PT4092 | WA | Primary |
Addresses
Primary practice location
7900 E Green Lake Dr N
Seattle, WA 98103-4800
Mailing address
432 NE Ravenna Blvd
Unit 101
Seattle, WA 98115-8448
Phone (206) 524-4977
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 144371 | Other | WA | LABOR & INDUSTRIES |
| 8363855 | Medicaid | WA |
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 |
|---|---|---|---|
| PT4092 | WA | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Physiotherapy Associates | 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 Therapy Clinic/Center
- Kirkland, WA
- NPI 1770521700
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1157414400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1527120000000",
"number": "1912009325",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "432 NE RAVENNA BLVD",
"address_2": "UNIT 101",
"city": "SEATTLE",
"state": "WA",
"postal_code": "981158448",
"telephone_number": "206-524-4977",
"fax_number": "206-524-4340"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7900 E GREEN LAKE DR N",
"city": "SEATTLE",
"state": "WA",
"postal_code": "981034800",
"telephone_number": "206-985-2236",
"fax_number": "206-985-2248"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BROLLEY",
"first_name": "WOLFGANG",
"name_prefix": "Mr.",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-09-05",
"last_updated": "2018-05-24",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "WA",
"license": "PT4092",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LABOR & INDUSTRIES",
"identifier": "144371",
"state": "WA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "8363855",
"state": "WA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Seattle, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 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.