Timothy William Clendaniel, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT60842251 Issued in WA

Practice address

4303 W 24TH Ave # B
Kennewick, WA 99338-1963

Phone

(509) 209-9386

Fax

(509) 396-3133

NPI assigned

Aug 14, 2018

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Northwest Center for Sports Medicine & Physical Therapy, Inc.

  dba Northwest Sports Physical Therapy

  • Physical Therapist
  • Gig Harbor, WA
  • NPI 1982755070
  NPD (past)

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

{
    "created_epoch": "1534204800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1534204800000",
    "number": "1952880569",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4906 GUEMES LN",
            "city": "PASCO",
            "state": "WA",
            "postal_code": "993017988",
            "telephone_number": "206-817-3736"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4303 W 24TH AVE # B",
            "city": "KENNEWICK",
            "state": "WA",
            "postal_code": "993381963",
            "telephone_number": "509-209-9386",
            "fax_number": "509-396-3133"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLENDANIEL",
        "first_name": "TIMOTHY",
        "middle_name": "WILLIAM",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-08-14",
        "last_updated": "2018-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WA",
            "license": "PT60842251",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Norma Larae Claybrook, R.N. I.B.C.L.C.
• Audra Darlene Clayton
• Clearly Lasik, Inc.
• Molly Anne Clemenson, M.T.
• Brian W Clemmons, M.A. LMHC
• Randall Shane Clower, PA-C
• Cochran Counseling Services LLC
• Patricia J Cochran, BA, MS, LMHC
• Dina Cohen, OTR
• Denise Colbray

• Physical Therapist in Kennewick, WA
• Providers in Kennewick, WA by specialty
• Physical Therapist in Washington

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

Verify at the official NPI Registry.