Provider Demographics
NPI:1144272980
Name:ADAMS, JUDY MARIE (MPT)
Entity type:Individual
Prefix:
First Name:JUDY
Middle Name:MARIE
Last Name:ADAMS
Suffix:
Gender:F
Credentials:MPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:950 PACIFIC AVE STE 900
Mailing Address - Street 2:
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98402-4425
Mailing Address - Country:US
Mailing Address - Phone:253-274-4600
Mailing Address - Fax:
Practice Address - Street 1:1880 POTTERY AVE STE 100
Practice Address - Street 2:KITSAP PHYSICAL THERAPY
Practice Address - City:PORT ORCHARD
Practice Address - State:WA
Practice Address - Zip Code:98366
Practice Address - Country:US
Practice Address - Phone:360-895-9090
Practice Address - Fax:360-895-9089
Is Sole Proprietor?:No
Enumeration Date:2006-05-17
Last Update Date:2021-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPT00005551225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA0191738OtherL & I
WA8415655Medicaid
912075994OtherKITSAP PHYSCIAL THERAPY &