G4 ATHLETE LLC (NPI# 1740689520) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1740689520 |
| Entity Type | Organization |
| Organization Name | G4 ATHLETE LLC |
| Other Organization Name | G4 ATHLETE |
| Practice Address |
2737 77th Ave Se Suite 214 Mercer Island WA 98040-2830 |
| Practice Telephone | 2065189405 |
| Practice Fax Number | 8558190086 |
| Mailing Telephone | 2065189405 |
| Enumeration Date | 2014-08-18 |
| Last Update Date | 2014-08-18 |
| Authorized Official Name | MR. BRENT M GEORGE (PHYSICAL THERAPIST/CLINIC OWNER) |
| Authorized Official Telephone | 2065189405 |
| Authorized Official Credential | MPT |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2251S0007X |
Physical Therapist Specialization: Sports |
603186027 | WA | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Other Name | Type Code |
|---|---|
| G4 Athlete | Doing Business As Name - Organization |
| Street Address |
2737 77TH AVE SE SUITE 214 |
| City | MERCER ISLAND |
| State | WA |
| Zip Code | 98040-2830 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649252164 | Brent M George | Physical Therapist | 2737 77th Ave Se, Ste 214, Mercer Island, WA 98040-2832 | 2005-11-18 |
| 1548680432 | Mike Gile Dds Pllc | Clinic/Center | 2737 77th Ave Se, 212, Mercer Island, WA 98040-2830 | 2014-04-18 |
| 1598928665 | Elizabeth K Ross | Physical Therapist | 2737 77th Ave Se, Suite 214, Mercer Island, WA 98040-2830 | 2008-07-08 |
| 1184766149 | Robert Carl Faine | Dentist | 2737 77th Ave Se, #212, Mercer Island, WA 98040-2830 | 2007-02-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902440266 | Michael Cottrell Johnson | Technician | 3812 W. Mercer Way, Mercer Island, WA 98040 | 2019-10-30 |
| 1881237048 | Lisa Catherine Stewart | Social Worker | Mental Health & Addiction Services, 401 Broadway, Seattle, WA 98040 | 2019-10-21 |
| 1023520665 | Aca Wa Group Corp | Massage Therapist | 7605 Se 27th St, Suite 103, Mercer Island, WA 98040 | 2017-11-03 |
| 1699211995 | Wei Fan | Acupuncturist | 7605 Se 27th Street, Suite 103, Mercer Island, WA 98040 | 2017-01-10 |
| 1346691953 | James M Blue | Neurological Surgery | 4882 Forest Ave S.e., Mercer Island, WA 98040 | 2016-06-24 |
| 1982058418 | Ray Johnson | Physician Assistant | 4446 88th Ave Se, Mercer Island, WA 98040 | 2016-04-21 |
| 1780072900 | The Emily Program PC | Psychiatric Residential Treatment Facility | 7275 N. Mercer Way, Mercer Island, WA 98040 | 2014-12-23 |
| 1609115641 | Richard Daifuku | Specialist | 9270 Se 36th Pl, Mercer Island, WA 98040 | 2013-02-12 |
| 1689937286 | Karin L. Miller | Social Worker | 9725 Se. 36 St. #301, Mercer Island, WA 98040 | 2012-06-19 |
| 1689947608 | Hector Cantu Aldape | Pathology | 7649 West Mercer Way, Mercer Island, WA 98040 | 2012-02-22 |
| Find all providers in zip 98040 | ||||
| Taxonomy Code | 2251S0007X |
| Grouping | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Classification | Physical Therapist |
| Specialization | Sports |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083941264 | Steven Wesley Heinrich | Physical Therapist | 1322 North Ash Street, Walgreens / Option Care Home Care, Spokane, WA 99201-2804 | 2009-11-10 |
| 1386252484 | Corey M O'malley Pt, Dpt, Pllc | Physical Therapist | 12707 120th Ave Ne Ste 100, Kirkland, WA 98034-7500 | 2020-07-15 |
| 1023671625 | Reverve LLC | Physical Therapist | 114 Alaskan Way S Apt 506, Seattle, WA 98104-2585 | 2019-04-18 |
| 1891276994 | Caitlin Paskewich | Physical Therapist | 110 110th Ave Ne Ste 110, Bellevue, WA 98004-5840 | 2018-08-27 |
| 1003218447 | Robert Joseph Roller Jr. | Physical Therapist | 9040 Jackson Ave, Tacoma, WA 98431-0001 | 2014-09-17 |
| 1629414123 | Michael James Tankovich | Physical Therapist | 12 Seahawks Way, Renton, WA 98056-1572 | 2013-05-11 |
| 1629192497 | Rebecca A Forkan | Physical Therapist | 20109 Aurora Ave N Ste 105, Shoreline, WA 98133-3127 | 2007-03-19 |
| 1407993553 | Randy A Notebloom | Physical Therapist | 904 7th Ave, Seattle, WA 98104-1132 | 2007-01-30 |
| 1356413280 | Jet City Enterprists Inc | Physical Therapist | 11304 8th Ave Ne, Suite A, Seattle, WA 98125-6111 | 2006-11-15 |
| 1922087386 | Erin E Patterson | Physical Therapist | Naval Hospital Bremerton, Bremerton, WA 98370-0000 | 2006-01-13 |
| Find all providers with the same taxonomy | ||||
| City | MERCER ISLAND |
| Zip Code | 98040 |
Please comment or provide details below to improve the information on G4 ATHLETE LLC.
| 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.