LAKE BURIEN PHYSICAL THERAPY (NPI# 1053545319) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1053545319 |
| Entity Type | Organization |
| Organization Name | LAKE BURIEN PHYSICAL THERAPY |
| Other Organization Name | LAKE BURIEN PHYSICAL THERAPY, INC |
| Practice Address |
15811 Ambaum Blvd Sw Suite 140 Burien WA 98166-3066 |
| Practice Telephone | 2063279880 |
| Practice Fax Number | 2063279977 |
| Mailing Telephone | 2063279880 |
| Mailing Fax Number | 2063279977 |
| Enumeration Date | 2009-05-14 |
| Last Update Date | 2009-11-24 |
| Authorized Official Name | DR. ORIT STEPHANIE HICKMAN (DOCTOR OF PHYSICAL THERAPY) |
| Authorized Official Telephone | 2063279880 |
| Authorized Official Credential | DPT |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 225100000X | Physical Therapist | 00010537 | WA | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Other Name | Type Code |
|---|---|
| Lake Burien Physical Therapy, Inc | Doing Business As Name - Organization |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Washington State Corporations | LAKE BURIEN PHYSICAL THERAPY INC. | 15811 Ambaum Blvd Sw, Suite 140, Burien, WA 98166-3066 |
| Street Address |
15811 AMBAUM BLVD SW SUITE 140 |
| City | BURIEN |
| State | WA |
| Zip Code | 98166-3066 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982652400 | Highline Medical Group Inc | Internal Medicine | 15811 Ambaum Blvd Sw, Suite A, Burien, WA 98166-3013 | 2006-05-05 |
| 1174096150 | Claire Louise Schaffer | Marriage & Family Therapist | 15811 Ambaum Blvd Sw, Ste 110, Burien, WA 98166 | 2019-01-02 |
| 1568905651 | Joseph Koenig | Physical Therapist | 15811 Ambaum Blvd Sw, Suite 140, Burien, WA 98166-3066 | 2016-11-22 |
| 1942617386 | Nicholas Pennacchi | Massage Therapist | 15811 Ambaum Blvd Sw, Ste 110, Burien, WA 98166-3066 | 2014-07-17 |
| 1962816280 | Dana Kahn | Counselor | 15811 Ambaum Blvd Sw, Suite 110, Burien, WA 98166-3066 | 2014-06-14 |
| 1588080626 | Counseling Services for Wellbeing, Inc. | Marriage & Family Therapist | 15811 Ambaum Blvd Sw, Suite 110, Burien, WA 98166 | 2014-03-13 |
| 1558702316 | Bryce Alikzandr Shoemaker | Counselor | 15811 Ambaum Blvd Sw, Suite 110, Burien, WA 98166-3066 | 2013-07-09 |
| 1295098812 | Lindsay Beth Ann Krull | Specialist | 15811 Ambaum Blvd Sw, Suite 110, Burien, WA 98166-3066 | 2012-06-19 |
| 1619268802 | Integrum Healthcare LLC | Clinic/Center | 15811 Ambaum Blvd Sw, Suite 110, Burien, WA 98166-3066 | 2011-04-22 |
| 1164733184 | Tovi Avnon | Psychiatry & Neurology | 15811 Ambaum Blvd Sw, Ste 110, Burien, WA 98166-3066 | 2010-06-24 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508341488 | Robert James Woodland Sr. | Counselor | 1210 Sw 136th St., Burien, WA 98166 | 2018-09-26 |
| 1215467329 | Amy Elizabeth Castillo | Massage Therapist | 1204 Sw 168th St, Normandy Park, WA 98166 | 2017-06-13 |
| 1053856070 | Michael David Blackledge | Physical Therapist | 15811 Ambaum Blvd Sw Ste 140, Burien, WA 98166 | 2016-12-29 |
| 1114372232 | Maris Gibson | Massage Therapist | 801 S.w. 150thst, #110, Burien, WA 98166 | 2016-04-26 |
| 1649642992 | Navos | Community/Behavioral Health | 31408 28th Ave South, 1201 Sw 136th Street, Burien, WA 98166 | 2015-10-27 |
| 1154790798 | Han Nguyen | Chiropractor | 15811 Ambaum Blvd Sw Suite 110, Burien, WA 98166 | 2015-09-24 |
| 1497163778 | Maria Garvey-caruso | Physical Therapist | 1511 Ambaum Blvd South West, Suite 140, Burien, WA 98166 | 2014-07-30 |
| 1427495274 | Mohammed Nayeemuddin | Internal Medicine | 16259 Sylvester Rd Sw Ste 404, Burien, WA 98166 | 2013-06-03 |
| 1023362753 | Donna Shaman | Occupational Therapist | 15675 Ambaum Blvd, Burien, WA 98166 | 2012-11-02 |
| 1366707010 | Tracy C Saephanh | Pharmacy Technician | 14901 4th Ave Sw Ste 100, Burien, WA 98166 | 2012-07-09 |
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| Taxonomy Code | 225100000X |
| Grouping | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Classification | Physical Therapist |
| (1) Physical therapists are health care professionals who evaluate and treat people with health problems resulting from injury or disease. PT’s assess joint motion, muscle strength and endurance, function of heart and lungs, and performance of activities required in daily living, among other responsibilities. Treatment includes therapeutic exercises, cardiovascular endurance training, and training in activities of daily living. (2) A physical therapist is a person qualified by an accredited program in physical therapy, licensed by the state, and practicing within the scope of that license. Physical therapists treat disease, injury, or loss of a bodily part by physical means, such as the application of light, heat, cold, water, electricity, massage and exercise. They develop treatment plans based upon each patient’s strengths, weaknesses, range of motion and ability to function. (3) A health professional who specializes in physical therapy- the health care field concerned primarily with the treatment of disorders with physical agents and methods, such as massage, manipulation, therapeutic exercises, cold, heat (including short-wave, microwave, and ultrasonic diathermy), hydrotherapy, electric stimulation and light to assist in rehabilitating patients and in restoring normal function after an illness or injury. |
| Notes: Source: (1) APTA Guidelines for Physical Therapy Claims Review, American Physical Therapy Association. (3) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, IL: 1994, p. 612 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093314460 | Aubrey L Scheffel | Physical Therapist | 16222 Sylvester Rd Sw, Burien, WA 98166-3018 | 2020-10-18 |
| 1053856070 | Michael David Blackledge | Physical Therapist | 15811 Ambaum Blvd Sw Ste 140, Burien, WA 98166 | 2016-12-29 |
| 1497163778 | Maria Garvey-caruso | Physical Therapist | 1511 Ambaum Blvd South West, Suite 140, Burien, WA 98166 | 2014-07-30 |
| 1467755397 | Southwest Seattle Physical Therapy and Sports Rehabilitaion | Physical Therapist | 15410 Ambaum Blvd Sw, Suite #103, Burien, WA 98166-2402 | 2010-12-15 |
| 1588706857 | Sherryl Lynn Devries | Physical Therapist | 1605 Sw 165th St, Burien, WA 98166-2743 | 2007-02-13 |
| 1750438529 | Bradford Bentley | Physical Therapist | 15623 1st Ave S Ste C, Burien, WA 98148-1292 | 2007-01-04 |
| 1851491955 | Ashley Clippard | Physical Therapist | 17694 1st Ave S, Suite A, Burien, WA 98148-1729 | 2006-09-25 |
| 1598725798 | Advance Physical Therapy Inc | Physical Therapist | 15623 1st Ave S, Ste C, Burien, WA 98148-1292 | 2006-03-23 |
| 1033100441 | Pierre-yves Frederic Butheau | Physical Therapist | 15034 5th Ln S, Burien, WA 98148-2551 | 2005-11-03 |
| 1689286494 | Lisa Marie Elsonbaty | Physical Therapist | 16259 Sylvester Rd Sw Ste 102, Burien, WA 98166-3094 | 2020-08-21 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.