# LIGHTHOUSE PHYSICAL THERAPY AND SPORTS MEDICINE

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Lighthouse PT & Sports Medicine
- **Organization subpart:** No

## Provider details

- **NPI number:** 1598364143
- **Authorized official:** TESSA CHRISTINE SHAFER (OFFICE MANAGER)
- **Authorized official phone:** (509) 928-3443

## Contact information

- **Practice address:** 18915 E APPLEWAY AVE A200, GREENACRES, WA 99016-0000
- **Practice address phone:** (509) 928-3443
- **Practice address fax:** (509) 891-5591
- **Mailing address:** 18915 E APPLEWAY AVE A200, GREENACRES, WA 99016-0000
- **Mailing address phone:** (509) 928-3443
- **Mailing address fax:** (509) 891-5591

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208100000X | Physical Medicine & Rehabilitation Physician | — | NULL | Yes |
| 208100000X | Physical Medicine & Rehabilitation Physician | — | — | Yes |

## Other

- **Enumeration date:** 10/23/2020
- **Last updated:** 06/13/2022