Mountlake Sports & Physical Therapy Ps

NPI #1528331402 in Everett, Washington

Provider Information

NPI Number: 1528331402
Entity Type: Organization
Organization Name: Mountlake Sports & Physical Therapy Ps
Primary Specialty: Physical Therapist
Enumeration Date: Feb 22, 2012
Last Updated: Feb 22, 2012

Practice Location

Address: 9505 19TH AVE SE
Address 2: 101
City: Everett
State: Washington
ZIP Code: 98208-3853
Phone: (425) 379-8120

Authorized Official

Name: JAMIE MALIJAN
Title: CLINICAL MANAGER
Phone: (425) 379-8120

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physical Therapist	225100000X	Primary
Massage Therapist	225700000X

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