Individual provider Active NPI

Ellen Forslund, D.P.T.

  • Physical Therapist
  • Bothell, WA
National Provider Identifier
1972057966
Registry record updated Aug 8, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT 60658313 Issued in WA
Practice address
1909 214TH St SE Ste 300
Bothell, WA 98021-4418
Phone
(425) 412-7200
NPI assigned
Aug 8, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 8, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT 60658313 WA Primary

Addresses

Primary practice location

1909 214TH St SE Ste 300
Bothell, WA 98021-4418

Mailing address

20314 84TH PL W
Edmonds, WA 98026-6606
Phone (425) 780-0289

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20161117001550 WA Practitioner - Physical Therapist in Private Practice 6709165533 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Pacmed ClinicsGroup PAC ID 2466350657, 211 clinicians

Practice addresses (Care Compare)

1101 Madison St
Suite 301
Seattle, WA 98104-3599
Phone (206) 505-1300

1801 Lind Ave SW
Renton, WA 98057-3368
Phone (425) 227-3700

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT 60658313WAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Pacmed Clinics CurrentSince Oct 9, 2016 Accepting new patients
Pacmed Clinics CurrentSince Oct 9, 2016 Accepting new patients
Pacmed Clinics Current Accepting new patients

Locations

1909 214th St SE
Ste 300
Bothell, WA 98021
Phone (425) 412-6335

220 15th Ave SE
Puyallup, WA 98372
Phone (253) 435-3400

601 S Carr Rd
Ste 100
Renton, WA 98055
Phone (425) 227-3700

1101 Madison St
Ste 301
Seattle, WA 98104
Phone (206) 505-1101

10416 5th Ave NE
Seattle, WA 98125
Phone (206) 517-6667

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1470614400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1470614400000",
    "number": "1972057966",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20314 84TH PL W",
            "city": "EDMONDS",
            "state": "WA",
            "postal_code": "980266606",
            "telephone_number": "425-780-0289"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1909 214TH ST SE STE 300",
            "city": "BOTHELL",
            "state": "WA",
            "postal_code": "980214418",
            "telephone_number": "425-412-7200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FORSLUND",
        "first_name": "ELLEN",
        "credential": "D.P.T.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-08-08",
        "last_updated": "2016-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WA",
            "license": "PT 60658313",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bothell, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.