Northwest Center for Sports Medicine & Physical Therapy Inc
NPI 1861057184ActiveOrganization· Physical Therapist· Mount Vernon, WA
Physical Therapist in Mount Vernon, Washington, registered in NPPES in May 2019. The authorized official on file is Kevin Johanneson, Vp Revenue Cycle.
Overview
| NPI | 1861057184 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | May 2, 2019 |
| Last updated in NPPES | May 2, 2019 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Physical Therapist Primary | 225100000X | — | — |
| Occupational Therapist | 225X00000X | — | — |
| Speech-Language Pathologist | 235Z00000X | — | — |
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) | Not in the public enrollment file of Oct 1, 2026 |
|---|
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