Physical Medicine Northwest

Primary specialty

Rehabilitation Clinic/CenterTaxonomy code 261QR0400X

License

MD 00038676 Issued in WA

Legal business name

PHYSICAL MEDICINE NORTHWEST

Practice address

549 Main St
Edmonds, WA 98020-3149

Phone

(425) 967-6974

Fax

(425) 967-5480

NPI assigned

Jul 27, 2016

Last updated

Jul 27, 2016By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Jeffery E Fitzthum, MDNPI 1962434142

Title

Owner/Provider

Phone

(425) 967-6974

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Jeffery Edward Fitzthum, M.D.

  • Physical Medicine & Rehabilitation Physician
  • Edmonds, WA
  • NPI 1962434142
  NPD (past) Authorized official

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

{
    "created_epoch": "1469577600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1469577600000",
    "number": "1932652823",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "549 MAIN ST",
            "city": "EDMONDS",
            "state": "WA",
            "postal_code": "980203149",
            "telephone_number": "425-967-6974",
            "fax_number": "425-967-5480"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "549 MAIN ST",
            "city": "EDMONDS",
            "state": "WA",
            "postal_code": "980203149",
            "telephone_number": "425-967-6974",
            "fax_number": "425-967-5480"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHYSICAL MEDICINE NORTHWEST",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-07-27",
        "last_updated": "2016-07-27",
        "status": "A",
        "authorized_official_last_name": "FITZTHUM",
        "authorized_official_first_name": "JEFFERY",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "OWNER/PROVIDER",
        "authorized_official_telephone_number": "425-967-6974",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QR0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation",
            "state": "WA",
            "license": "MD 00038676",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• PHD#2 of Snohomish County (Stevens Hospital, Stevens Memorial Hospital)
• PHD#2 of Snohomish County (Stevens Hospital Pharmacy)
• PHD2 of Snohomish County (Stevens Center for Internal Medicine)
• Richard Claude Phillips, MD, MS, MPH
• Ame Phitwong, ARNP
• Picnic Point Villa Afh LLC
• Cynthia Piepenbrok, LMHC
• Kelby Iris Pierce
• Gwendolyn Piercey, A.R.N.P.
• Carrie Pilger, M.A.

• Rehabilitation Clinic/Center in Edmonds, WA
• Providers in Edmonds, WA by specialty
• Rehabilitation Clinic/Center in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2016; 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.