Benjamin Randolph Grover, DPT
Individual provider Active NPI Physical Therapist · Fircrest, WA
NPI 1982941001 · NPPES record last updated May 7, 2013
Key facts
- NPI
- 1982941001
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapist 225100000X
- License
- PT60274732 (WA)
- Practice address
- 4040 Orchard St W
Ste. 100
Fircrest, WA 98466-6606 - Phone
- (253) 564-1560
- Fax
- (253) 564-4449
- NPI assigned
- Jan 9, 2013
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PT60274732 | WA | MD | Physical Therapist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | PT60274732 | WA | Yes |
Addresses
Primary practice location
4040 Orchard St W
Ste. 100
Fircrest, WA 98466-6606
Mailing address
4040 Orchard St W
Ste. 100
Fircrest, WA 98466-6606
Phone (253) 564-1560
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0306754 | Other | WA | STATE OF WASHINGTON DEPT. OF LABOR AND INDUSTRIES |
Other providers in Fircrest, WA
- Fircrest Pharmacy
- Silvia Tina Fradkin
- James Patrick Gagliardi
- Spencer David Garlick
- Grit City Chiropractic, PLLC
- Kimberley Louise Gruening McNickle
- Adriana Haberlach
- Nevin Michael Hair
- Ryan Hannig
- Erick Albert Hartman
All providers in Fircrest, WA · Physical Therapist in Washington
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 7, 2013. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.