Basic Information
| Provider Information | |||||||||
| NPI: | 1831232651 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | ALLIANCE PHYSICAL THERAPY LLC | ||||||||
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| OtherOrganizationName: | MIDWAY PHYSICAL THERAPY | ||||||||
| OtherOrganizationType: | 3 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 34507 PACIFIC HWY S STE 6 | ||||||||
| Address2: | |||||||||
| City: | FEDERAL WAY | ||||||||
| State: | WA | ||||||||
| PostalCode: | 980036879 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2068243668 | ||||||||
| FaxNumber: | 2068243964 | ||||||||
| Practice Location | |||||||||
| Address1: | 22659 PACIFIC HWY S STE 201 | ||||||||
| Address2: | |||||||||
| City: | DES MOINES | ||||||||
| State: | WA | ||||||||
| PostalCode: | 981985155 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2068243668 | ||||||||
| FaxNumber: | 2068243964 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/14/2007 | ||||||||
| LastUpdateDate: | 08/22/2020 | ||||||||
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| AuthorizedOfficialLastName: | ROBBLEE | ||||||||
| AuthorizedOfficialFirstName: | KAREN | ||||||||
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| AuthorizedOfficialTitleorPosition: | BUSINESS MANAGER | ||||||||
| AuthorizedOfficialTelephone: | 2538382464 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2251X0800X | PT00009231 | WA | Y | 193400000X SINGLE SPECIALTY GROUP | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist | Orthopedic |
ID Information
| ID | Type | State | Issuer | Description | 7099658 | 05 | WA | MEDICAID |