Provider Demographics
NPI:1487692398
Name:SNOHOMISH PHYSICAL THERAPY PLLC
Entity type:Organization
Organization Name:SNOHOMISH PHYSICAL THERAPY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VP/AUTHORIZED OFFICIAL
Authorized Official - Prefix:
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:
Authorized Official - Last Name:BINSTEIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:713-297-7000
Mailing Address - Street 1:1830 BICKFORD AVE STE 209
Mailing Address - Street 2:
Mailing Address - City:SNOHOMISH
Mailing Address - State:WA
Mailing Address - Zip Code:98290-1750
Mailing Address - Country:US
Mailing Address - Phone:360-568-7774
Mailing Address - Fax:
Practice Address - Street 1:1830 BICKFORD AVE
Practice Address - Street 2:SUITE 209
Practice Address - City:SNOHOMISH
Practice Address - State:WA
Practice Address - Zip Code:98290-1749
Practice Address - Country:US
Practice Address - Phone:360-568-7774
Practice Address - Fax:360-568-7779
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-03
Last Update Date:2019-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA225700000X
225XH1200X, 261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
No225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty
No225XH1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistHandGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA3158SNOtherREGENCE BLUESHIELD GRP #
WA7119167Medicaid
WA0175764OtherDEPT. OF LABOR & INDUSTRY
WADA5809OtherRAILROAD MEDICARE
WA8932322OtherL&I CRIME VICTIMS
WA1028001-00OtherOWCP
WA9054990Medicaid
WA3158SNOtherREGENCE BLUESHIELD GRP #
WA0175764OtherDEPT. OF LABOR & INDUSTRY