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Organization

PEAK ORTHOPEDIC & SPORTS PHYSICAL THERAPY INC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
BRIAN J RUSSON MS PT ATC (OWNER)
(360) 794-7520
Entity
Organization

Contact information

Practice address
14841 179TH AVE SE, SUITE 340, MONROE, WA 98272-1127
(360) 794-7520
(360) 794-8947
Mailing address
14841 179TH AVE SE, SUITE 340, MONROE, WA 98272-1127
(360) 794-7520
(360) 794-8947

Taxonomy

Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
PT0000754
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
7116288
WA
Enumeration date
09/12/2007
Last updated
06/18/2025
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