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Organization

MAPLE VALLEY PHYSICAL THERAPY, INC.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. CLIFFORD JOHN RICHARDS PT (OWNER)
(425) 432-1671
Entity
Organization

Contact information

Practice address
23870 SE KENT KANGLEY RD, MAPLE VALLEY, WA 98038-6848
(425) 432-1671
(425) 432-1677
Mailing address
22443 SE 240 ST, SUITE 201, MAPLE VALLEY, WA 98038
(425) 432-1671
(425) 432-1677

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
5147
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0165RI
REGENCE
WA
01
0191071
L&I
WA
01
5147
UPIN
WA
01
609471200
OWCP
WA
01
P00279139
RAILROAD MEDICARE
WA
Enumeration date
12/12/2007
Last updated
04/13/2012
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