Provider Demographics
NPI:1174562953
Name:OLYMPIA PHYSICAL THERAPY & INDUSTRIAL REHABILITATION, INC.
Entity type:Organization
Organization Name:OLYMPIA PHYSICAL THERAPY & INDUSTRIAL REHABILITATION, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MPT / OWNER
Authorized Official - Prefix:
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:ANTHONY
Authorized Official - Last Name:ROBBINS
Authorized Official - Suffix:
Authorized Official - Credentials:MPT
Authorized Official - Phone:360-352-5077
Mailing Address - Street 1:2755 MOTTMAN RD SW
Mailing Address - Street 2:
Mailing Address - City:TUMWATER
Mailing Address - State:WA
Mailing Address - Zip Code:98512-5684
Mailing Address - Country:US
Mailing Address - Phone:360-352-5077
Mailing Address - Fax:360-352-5022
Practice Address - Street 1:2755 MOTTMAN RD SW
Practice Address - Street 2:
Practice Address - City:TUMWATER
Practice Address - State:WA
Practice Address - Zip Code:98512-5684
Practice Address - Country:US
Practice Address - Phone:360-352-5077
Practice Address - Fax:360-352-5022
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-06
Last Update Date:2024-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA0167743OtherSTATE LABOR & INDUSTRIES
WA7115074Medicaid
WACK7840OtherRAILROAD MEDICARE
WA017966-0001OtherPACIFICARE
WA0167743OtherSTATE LABOR & INDUSTRIES