Individual provider Active NPI

Thomas Warren Young, DPT

  • Physical Therapist
  • Puyallup, WA
National Provider Identifier
1982992079
Registry record updated Jul 11, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT60227690 Issued in WA
Practice address
8011 112TH Street CT E
Puyallup, WA 98373-7814
Phone
(253) 848-0662
Fax
(253) 848-8567
NPI assigned
Jul 11, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 11, 2011

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 PT60227690 WA Primary

Addresses

Primary practice location

8011 112TH Street CT E
Puyallup, WA 98373-7814

Mailing address

9315 Gravelly Lake Dr SW
Suite 306
Lakewood, WA 98499-1574
Phone (253) 581-5200

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

LicenseStateTypeSpecialty
PT60227690WAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Olympic Sports and Spine Rehabilitation, P.S. Physical Therapist 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.

NPI Registry JSON

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

{
    "created_epoch": "1310342400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1310342400000",
    "number": "1982992079",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9315 GRAVELLY LAKE DR SW",
            "address_2": "SUITE 306",
            "city": "LAKEWOOD",
            "state": "WA",
            "postal_code": "984991574",
            "telephone_number": "253-581-5200",
            "fax_number": "253-581-5203"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8011 112TH STREET CT E",
            "city": "PUYALLUP",
            "state": "WA",
            "postal_code": "983737814",
            "telephone_number": "253-848-0662",
            "fax_number": "253-848-8567"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YOUNG",
        "first_name": "THOMAS",
        "middle_name": "WARREN",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-07-11",
        "last_updated": "2011-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WA",
            "license": "PT60227690",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Puyallup, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2011; 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.