Provider Demographics
NPI:1447322185
Name:MACARTHUR PHYSICAL THERAPY & MONROE SPORTS THERAPY
Entity type:Organization
Organization Name:MACARTHUR PHYSICAL THERAPY & MONROE SPORTS THERAPY
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:HUGH
Authorized Official - Last Name:MACARTHUR
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:360-794-4892
Mailing Address - Street 1:17792 147TH ST SE
Mailing Address - Street 2:
Mailing Address - City:MONROE
Mailing Address - State:WA
Mailing Address - Zip Code:98272-1030
Mailing Address - Country:US
Mailing Address - Phone:360-794-4892
Mailing Address - Fax:360-794-4679
Practice Address - Street 1:17792 147TH ST SE
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:WA
Practice Address - Zip Code:98272-1030
Practice Address - Country:US
Practice Address - Phone:360-794-4892
Practice Address - Fax:360-794-4679
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-15
Last Update Date:2010-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA7083330Medicaid
WAGAB26219Medicare ID - Type UnspecifiedMONROESPORTSTHERPNUMBER