Provider Demographics
NPI:1174945224
Name:ATLAS PHYSICAL THERAPY & INDUSTRIAL REHABILITATION PLLC
Entity type:Organization
Organization Name:ATLAS PHYSICAL THERAPY & INDUSTRIAL REHABILITATION PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:TITONATH
Authorized Official - Middle Name:
Authorized Official - Last Name:DITH
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:206-423-0899
Mailing Address - Street 1:13410 HIGHWAY 99 STE 204
Mailing Address - Street 2:
Mailing Address - City:EVERETT
Mailing Address - State:WA
Mailing Address - Zip Code:98204-5454
Mailing Address - Country:US
Mailing Address - Phone:425-742-7300
Mailing Address - Fax:425-742-7334
Practice Address - Street 1:13410 HIGHWAY 99 STE 204
Practice Address - Street 2:
Practice Address - City:EVERETT
Practice Address - State:WA
Practice Address - Zip Code:98204-5454
Practice Address - Country:US
Practice Address - Phone:425-742-7300
Practice Address - Fax:425-742-7334
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-01-09
Last Update Date:2014-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPT 00008126261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy