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NPI 1174361901ActiveIndividual· Physical Therapist· Olympia, WA
Physical Therapist with Multicare Health System, practicing in Olympia, Washington. Medicare paid $19,998 for services to 90 patients in 2024.
Overview
| NPI | 1174361901 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Sole proprietor | No |
| NPI issued | Jul 16, 2024 |
| Last updated in NPPES | Apr 8, 2026 |
| Certified by provider | Apr 8, 2026 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Physical Therapist Primary | 225100000X | PT.PT.61590619-CP | WA |
| Physical Therapist | 225100000X | 1683024 | WI |
| Physical Therapist | 225100000X | CP036910T | CO |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Practitioner - Physical Therapist in Private Practice (OH); Practitioner - Physical Therapist in Private Practice (WA) |
|---|---|
| Accepts assignment | Yes (participating) |
Medicare services in 2024
| Medicare patients | 90 |
|---|---|
| Services billed | 810 across 8 procedure codes |
| Paid by Medicare | $19,998 |
Education and affiliations
| Graduation year | 2024 |
|---|---|
| Medicare specialty | Physical Therapist In Private Practice |
Medical group
- Multicare Health SystemTacoma, WA · 2,325 clinicians
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All 173 physical therapists in Olympia · All physical therapists in Washington