Mountlake Sports & Physical Therapy Ps
NPI 1528331402ActiveOrganization· Physical Therapist· Everett, WA
Physical Therapist in Everett, Washington, registered in NPPES in February 2012. The authorized official on file is Jamie Malijan, Clinical Manager. Enrolled in Medicare as part b supplier - physical/occupational therapy group in private practice.
Overview
| NPI | 1528331402 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Feb 22, 2012 |
| Last updated in NPPES | Feb 22, 2012 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Physical Therapist Primary | 225100000X | PT00003917 | WA |
| Physical Therapist | 225100000X | PT60178380 | WA |
| Massage Therapist | 225700000X | MA00018299 | WA |
| Massage Therapist | 225700000X | MA00015079 | 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 10, 2026 | No match | — |
| New York OMIG · Nov 10, 2026 | No match | — |
| Ohio Medicaid · Nov 10, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 10, 2026 | No match | — |
| Washington HCA · Nov 10, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Part B Supplier - Physical/Occupational Therapy Group in Private Practice (WA) |
|---|
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