NPI Record of SNOHOMISH CLINIC (SUMMIT REHABILITATION LLC) NPI 1003003591

Physical Therapist in Snohomish, WA

Complete NPI Record

Field Name Value Definition
NPI1003003591The 10-position all-numeric identification number assigned by the NPS to uniquely identify a health care provider. The NPI number includes an ISO standard check-digit in the 10th position. There is no intelligence about the health care provider in the number.
Entity Type Code2Code describing the type of health care provider that is being assigned an NPI. Codes are 1 = (Person): individual human being who furnishes health care; 2 = (Non-person): entity other than an individual human being that furnishes health care (for example, hospital, SNF, hospital subunit, pharmacy, or HMO).
Employer Identification Number EINUNAVAILThe Employer Identification Number (EIN), assigned by the IRS, of the provider being identified.
Provider Organization Name Legal Business NameSUMMIT REHABILITATION LLCThe name of the organization provider. If the provider is an organization, this is the legal business name.
Provider Other Organization NameSNOHOMISH CLINICOther name by which the organization provider is or has been known.
Provider Other Organization Name Type Code5Code identifying the type of other name. Codes are: 1 = former name; 2 = professional name; 3 = doing business as (d/b/ a) name; 4 = former legal business name; 5 = other.
Provider First Line Business Mailing Address11805 N CREEK PKWY SThe first line mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider first line location address’’.
Provider Second Line Business Mailing AddressSUITE 113The second line mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider second line location address’’.
Provider Business Mailing Address City NameBOTHELLThe city name in the mailing address of the provider being identified.
Provider Business Mailing Address State NameWAThe State or Province name in the mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider location address State name’’.
Provider Business Mailing Address Postal Code980118803The postal ZIP or zone code in the mailing address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available. This data element may contain the same information as ‘‘Provider location address postal code’’.
Provider Business Mailing Address Country Code If outside U S USThe country code in the mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider location address country code’’.
Provider Business Mailing Address Telephone Number4258065700The telephone number associated with mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider location address telephone number’’.
Provider Business Mailing Address Fax Number4258065701The fax number associated with the mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider location address fax number’’.
Provider First Line Business Practice Location Address231 AVENUE DThe first line location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
Provider Business Practice Location Address City NameSNOHOMISHThe city name in the location address of the provider being identified.
Provider Business Practice Location Address State NameWAThe State code in the location of the provider being identified.
Provider Business Practice Location Address Postal Code982902744The postal ZIP or zone code in the location address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available.
Provider Business Practice Location Address Country Code If outside U S USThe country code in the location address of the provider being identified.
Provider Business Practice Location Address Telephone Number3605631020The telephone number associated with the location address of the provider being identified.
Provider Business Practice Location Address Fax Number3605639040The fax number associated with the location address of the provider being identified.
Provider Enumeration Date9/27/2007The date the provider was assigned a unique identifier (assigned an NPI).
Last Update Date3/24/2008The date that a record was last updated or changed.
Authorized Official Last NameBAKERThe last name of the person authorized to submit the NPI application or to change NPS data for a health care provider.
Authorized Official First NameDEBBIEThe first name of the authorized official.
Authorized Official Title or PositionFINANCE DIRECTORThe title or position of the authorized official.
Authorized Official Telephone Number4258065700The 10-position telephone number of the authorized official.
Healthcare Provider Taxonomy Code 1225100000XCode designating the provider type, classification, and specialization. Codes are from the Healthcare Provider Taxonomy code list. The NPS will associate these data with the license data for providers with Entity type code = 1.
Healthcare Provider Primary Taxonomy Switch 1Y
Is Organization SubpartY
Parent Organization LBNHEALTHFORCE PARTNERS
Parent Organization TINUNAVAIL
Authorized Official Name Prefix TextMISS
Healthcare Provider Taxonomy Group 1193400000X SINGLE SPECIALTY GROUP