Organization
NORTHWEST SPORTS PERFORMANCE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. KEVIN LEE VANDENBOSCH (MANAGER)
(206) 519-0135
Entity
Organization
Contact information
Practice address
819 PACIFIC AVE, TACOMA, WA 98402-5209
(253) 215-6100
Mailing address
15916 93RD AVE E, PUYALLUP, WA 98375-6718
(206) 519-0135
Taxonomy
Speciality
Code
Description
License number
State
133N00000X
Nutritionist
—
—
2081S0010X
Sports Medicine (Physical Medicine & Rehabilitation) Physician
—
—
2251S0007X
Sports Physical Therapist
Primary
—
—
225700000X
Massage Therapist
—
—
363L00000X
Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1770083826
PHYSICAL THERAPIST NPI
—
Enumeration date
08/08/2023
Last updated
08/08/2023
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us