1124591060 NPI number — EMERALD PHYSICAL THERAPY AND PILATES, PLLC

Table of content: MS. BARBARA ANN CELLI LCSW (NPI 1801877154)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1124591060 NPI number — EMERALD PHYSICAL THERAPY AND PILATES, PLLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
EMERALD PHYSICAL THERAPY AND PILATES, PLLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1124591060
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
01/03/2019
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
409 NE 85TH ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SEATTLE
Provider Business Mailing Address State Name:
WA
Provider Business Mailing Address Postal Code:
98115-2926
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
206-775-5454
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1401 NW 70TH ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SEATTLE
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98117-5340
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
206-708-6766
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
01/03/2019

Additional Information

Authorized Official

Authorized Official Last Name:
CHERNAK
Authorized Official First Name:
SAMANTHA
Authorized Official Middle Name:
Authorized Official Title or Position:
DIRECTOR
Authorized Official Telephone Number:
206-775-5454

Provider Taxonomy Codes

  • Taxonomy code: 261QP2000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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