Provider Demographics
NPI:1538823026
Name:GO FORWARD PHYSICAL THERAPY, PLLC
Entity type:Organization
Organization Name:GO FORWARD PHYSICAL THERAPY, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER, PHYSICAL THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:ERIKA
Authorized Official - Middle Name:R
Authorized Official - Last Name:SAGLE
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:253-906-1041
Mailing Address - Street 1:3914 N 11TH ST
Mailing Address - Street 2:
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98406-5012
Mailing Address - Country:US
Mailing Address - Phone:253-906-1041
Mailing Address - Fax:
Practice Address - Street 1:2611 N STEVENS ST
Practice Address - Street 2:
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98407-4670
Practice Address - Country:US
Practice Address - Phone:253-906-1041
Practice Address - Fax:253-302-4419
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-10-29
Last Update Date:2022-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAPT00010211OtherWASHINGTON PT LICENSE