PINE LAKE PHYSICAL THERAPY & SPORTS REHAB, P.S. - NPI 1356471684

Q: What is Pine Lake Physical Therapy & Sports Rehab, P.S.'s specialty?

The primary specialty registered for this NPI is Physical Therapist, specializing in Orthopedic, with taxonomy code 2251X0800X.

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About Pine Lake Physical Therapy & Sports Rehab, P.s. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

PINE LAKE PHYSICAL THERAPY & SPORTS REHAB, P.S. (NPI 1356471684) is a healthcare organization registered as an orthopedic in Sammamish, Washington and active in the NPI registry since March 2007. The organization lists Ronald Dean Enyeart, Owner, as its authorized official.

NPPES Registry Identity

NPI1356471684

Entity TypeOrganization

Primary Taxonomy2251X0800X

Legal Business NamePINE LAKE PHYSICAL THERAPY & SPORTS REHAB, P.S.

Location Address2850 228TH AVE SE, SUITE BSammamish, WA 98075-9301

Mailing Address2850 228th Ave Se, Suite BSammamish, WA 98075-9301 · (425) 391-4488 · Fax (425) 391-8287

Phone(425) 391-4488

Fax(425) 391-8287

Organization SubpartNo

Authorized OfficialRonald Dean EnyeartOwner · (425) 391-4488

Enumeration DateMarch 6, 2007

Last NPPES UpdateMarch 19, 2009

✔ NPI 1356471684 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysical Therapist · OrthopedicRespiratory, Developmental, Rehabilitative and Restorative Service Providers

Taxonomy Code2251X0800X

License✔ Licensed in WA · PT00003047

Definition

A licensed physical therapist, including but not limited to an individual who is a Board Certified Specialist in Orthopaedic Physical Therapy, who has demonstrated specialized knowledge and skill in human anatomy and physiology, movement science; pathology/pathophysiology, pain science, medical and surgical considerations, orthopaedic physical therapy theory and practice, and critical inquiry for evidence-based practice.

2850 228TH AVE SE, Sammamish, WA 98075

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Other Identifiers 1

Medicare ID-Type UnspecifiedGAB18245WA · Medicare Group

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Premera Blue Cross Blue Shield of Alaska.Insurance ›

Other Providers at the Same Location NPPES 5

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

ROBERT RANDALL THOMAS D.P.T.

Physical Therapist