MOUNTLAKE SPORTS & PHYSICAL THERAPY PS
NPI 1528331402
Physical Therapist in Everett, WA

Active since February 22, 2012
9505 19TH AVE SE, 101, EVERETT, WA 98208(425) 379-8120(425) 338-1789 Get Directions Write a Review

NPPES record last updated: February 22, 2012. Verified against the NPPES registry weekly; last sync: November 01, 2026.

About Mountlake Sports & Physical Therapy Ps NPPES

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

MOUNTLAKE SPORTS & PHYSICAL THERAPY PS (NPI 1528331402) is a healthcare organization registered as a physical therapist in Everett, Washington and active in the NPI registry since February 2012. The organization lists Jamie Malijan, Clinical Manager, as its authorized official.

NPPES Registry Identity

NPI1528331402
Entity TypeOrganization
Primary Taxonomy225100000X
Legal Business NameMOUNTLAKE SPORTS & PHYSICAL THERAPY PS
Location Address9505 19TH AVE SE, 101Everett, WA 98208-3853
Mailing Address9505 19th Ave Se, 101Everett, WA 98208-3853 · (425) 379-8120 · Fax (425) 338-1789
Fax(425) 338-1789
Organization SubpartNo
Authorized OfficialJamie MalijanClinical Manager · (425) 379-8120
Enumeration DateFebruary 22, 2012
✔ NPI 1528331402 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPhysical TherapistRespiratory, Developmental, Rehabilitative and Restorative Service Providers
Taxonomy Code225100000X
Licenses✔ Licensed in WA · PT00003917✔ Licensed in WA · PT60178380
Definition
Physical therapists (PTs) are licensed health care professionals who diagnose and treat individuals of all ages, from newborns to the very oldest, who have medical problems or other health-related conditions that limit their abilities to move and perform functional activities in their daily lives. PTs examine each individual and develop a plan using treatment techniques to promote the ability to move, reduce pain, restore function, and prevent disability. In addition, PTs work with individuals to prevent the loss of mobility before it occurs by developing fitness- and wellness-oriented programs for healthier and more active lifestyles. PTs:
  • Diagnose and manage movement dysfunction and enhance physical and functional abilities.
  • Restore, maintain, and promote not only optimal physical function but optimal wellness and fitness and optimal quality of life as it relates to movement and health.
  • Prevent the onset, symptoms, and progression of impairments, functional limitations, and disabilities that may result from diseases, disorders, conditions, or injuries.
  • Treat conditions of the musculoskeletal, neuromuscular, cardiovascular, pulmonary, and/or integumentary systems.
  • Address the negative effects attributable to unique personal and environmental factors as they relate to human performance.
PTs provide care for people in a variety of settings, including hospitals, private practices, outpatient clinics, home health agencies, schools, sports and fitness facilities, work settings, and nursing homes. State licensure is required in each state in which a PT practices.
Also ListedMassage TherapistTaxonomy 225700000X · License MA00018299 (WA), MA00015079 (WA)
9505 19TH AVE SE, Everett, WA 98208

Other Identifiers 2

Other0151396WA · Department Of Labor & Industries
Medicaid7084650WA

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Accepted Insurance

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Mountlake Sports & Physical Therapy Ps is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 1 clinician reassigns Medicare billing to Mountlake Sports & Physical Therapy Ps, which bills Medicare for the services this clinician delivers.

Clinician (1)

Physical Therapist in Private Practice
NPI 1588718027
9505 19TH AVE SE SUITE 101
Everett, WA 98208
(425) 379-8120
✔ Accepts Medicare0.1 mi

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Mountlake Sports & Physical Therapy Ps's NPI number?

The NPI number for Mountlake Sports & Physical Therapy Ps is 1528331402. It was assigned to this organization in the NPPES registry on February 22, 2012.

Where is Mountlake Sports & Physical Therapy Ps located?

Mountlake Sports & Physical Therapy Ps is located at 9505 19th Ave SE 101, Everett, WA 98208. The listed phone number is (425) 379-8120.

What is Mountlake Sports & Physical Therapy Ps's specialty?

The primary specialty registered for this NPI is Physical Therapist with taxonomy code 225100000X.

Is Mountlake Sports & Physical Therapy Ps enrolled in Medicare?

Yes. Mountlake Sports & Physical Therapy Ps is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Mountlake Sports & Physical Therapy Ps?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Physical Therapist in Private Practice) reassigns their Medicare billing to Mountlake Sports & Physical Therapy Ps. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

What insurance does Mountlake Sports & Physical Therapy Ps accept?

Health plans from Ambetter Health and Premera Blue Cross Blue Shield of Alaska list Mountlake Sports & Physical Therapy Ps as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Mountlake Sports & Physical Therapy Ps was last updated on February 22, 2012. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.