Walla Walla Physical Therapy Center Aps
NPI 1477574606ActiveOrganization· Physical Therapist· Walla Walla, WA
Physical Therapist in Walla Walla, Washington, registered in NPPES in July 2006. The authorized official on file is Michael J. Clark, PT, Physical Therapist/Owner. Enrolled in Medicare as part b supplier - clinic/group practice.
Overview
| NPI | 1477574606 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Jul 22, 2006 |
| Last updated in NPPES | Jun 22, 2023 |
| Certified by provider | Jun 22, 2023 |
| Reactivated | Jun 22, 2023 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Physical Therapist Primary | 225100000X | 601 755 670 | WA |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 4, 2026 | No match | — |
| New York OMIG · Nov 4, 2026 | No match | — |
| Ohio Medicaid · Nov 4, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 4, 2026 | No match | — |
| Washington HCA · Nov 4, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Part B Supplier - Clinic/Group Practice (WA) |
|---|
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