# PHYSICAL MEDICINE NORTHWEST

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1932652823
- **Authorized official:** JEFFERY E FITZTHUM MD (OWNER/PROVIDER)
- **Authorized official phone:** (425) 967-6974

## Contact information

- **Practice address:** 549 MAIN ST, EDMONDS, WA 98020-3149
- **Practice address phone:** (425) 967-6974
- **Practice address fax:** (425) 967-5480
- **Mailing address:** 549 MAIN ST, EDMONDS, WA 98020-3149
- **Mailing address phone:** (425) 967-6974
- **Mailing address fax:** (425) 967-5480

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QR0400X | Rehabilitation Clinic/Center | MD 00038676 | WA | Yes |

## Other

- **Enumeration date:** 07/27/2016
- **Last updated:** 07/27/2016