| |
1818 S Union Ave Ste 1b, Tacoma, WA 98405-1953 | |
(253) 627-7012 | |
(253) 627-7014 |
Full Name | |
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Type | Facility |
Speciality | Clinic/center - Physical Therapy |
Location | 1818 S Union Ave Ste 1b, Tacoma, Washington |
Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1841369048 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
225100000X | Physical Therapist | (* (Not Available)) | Secondary |
261QP2000X | Clinic/center - Physical Therapy | PT 8422 (Washington) | Primary |
Provider Name | Keith M Reagan |
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Provider Type | Practitioner - Physical Therapist In Private Practice |
Provider Identifiers | NPI Number: 1033176003 PECOS PAC ID: 8527073600 Enrollment ID: I20060210000101 |
Provider Name | Justin E Emerson |
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Provider Type | Practitioner - Physical Therapist In Private Practice |
Provider Identifiers | NPI Number: 1255923041 PECOS PAC ID: 8325457864 Enrollment ID: I20210512002884 |
Mailing Address | Practice Location Address |
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1818 S Union Ave Ste 1b, Tacoma, WA 98405-1953 Ph: (253) 627-7012 | 1818 S Union Ave Ste 1b, Tacoma, WA 98405-1953 Ph: (253) 627-7012 |