Organization
WINTHROP PHYSICAL THERAPY PS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PETER B DICKINSON MSPT, SCS (OWNER/PRESIDENT)
(509) 996-8234
Entity
Organization
Contact information
Practice address
202 WHITE AVE, WINTHROP, WA 98862-9774
(509) 996-8234
(509) 996-2193
Mailing address
PO BOX 814, WINTHROP, WA 98862-0814
(509) 996-8234
(509) 996-2193
Taxonomy
Speciality
Code
Description
License number
State
2251S0007X
Sports Physical Therapist
Primary
602118917
WA
332BC3200X
Customized Equipment (DME)
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0200051
LABOR & INDUSTRIES
WA
01
—
193601200
US DEPT OF LABOR OWCP
WA
01
—
602118917
UNIFIED BUSINESS IDENTIFI
WA
05
—
7120769
—
WA
Enumeration date
03/09/2006
Last updated
11/11/2010
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