Mindful Movement Physical Therapy, LLC
Physical Therapist in Lynnwood, WA. Organization (NPI-2).
NPI number1346684792
StatusActive
Last updated in NPPESApr 15, 2020
Details
- NPI
- 1346684792
- Entity type
- Organization (NPI-2)
- Legal business name
- Mindful Movement Physical Therapy, LLC
- Organization subpart
- No
- Enumeration date
- Apr 28, 2013
- Certification date
- Apr 15, 2020
- Last updated
- Apr 15, 2020
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 225100000X | Physical Therapist | PT00005338 | WA | Yes |
Practice location
3005 Alderwood Mall PkwySuite 100
Lynnwood, WA 98036-6920
Phone 206-979-1413
Mailing address
Po Box 1570Monroe, WA 98272-4570
Phone 360-799-6921 · Fax 360-799-6922
Authorized official
Susan Mazzaferro-Knowles
Owner
2069791413
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