Provider Demographics
NPI:1437021458
Name:ANDERSON PHYSICAL THERAPY
Entity type:Organization
Organization Name:ANDERSON PHYSICAL THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CREDENTIALING MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:JESSICA
Authorized Official - Middle Name:
Authorized Official - Last Name:RYBURN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:360-588-4145
Mailing Address - Street 1:24719 59TH AVE NE
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:WA
Mailing Address - Zip Code:98223-9782
Mailing Address - Country:US
Mailing Address - Phone:425-760-8034
Mailing Address - Fax:425-962-9449
Practice Address - Street 1:24719 59TH AVE NE
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:WA
Practice Address - Zip Code:98223-9782
Practice Address - Country:US
Practice Address - Phone:425-760-8034
Practice Address - Fax:425-962-9449
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-09-19
Last Update Date:2025-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty