Provider Demographics
NPI:1447718556
Name:NORTH PENINSULA PHYSICAL THERAPY, PLLC
Entity type:Organization
Organization Name:NORTH PENINSULA PHYSICAL THERAPY, PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:BUSINESS MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:MIEKA
Authorized Official - Middle Name:
Authorized Official - Last Name:EISEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:360-528-3300
Mailing Address - Street 1:111 TUMWATER BLVD SE STE 113
Mailing Address - Street 2:
Mailing Address - City:TUMWATER
Mailing Address - State:WA
Mailing Address - Zip Code:98501-6422
Mailing Address - Country:US
Mailing Address - Phone:360-528-3300
Mailing Address - Fax:360-528-8162
Practice Address - Street 1:19980 10TH AVE NE STE 201
Practice Address - Street 2:
Practice Address - City:POULSBO
Practice Address - State:WA
Practice Address - Zip Code:98370-6322
Practice Address - Country:US
Practice Address - Phone:360-598-1538
Practice Address - Fax:360-598-1541
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-03-07
Last Update Date:2025-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy