| Proactive Sportsmed | |
|
4200 6th Ave Se Ste 203, Lacey, WA 98503-1042 | |
| (360) 455-4448 | |
| (360) 455-9833 |
| Full Name | Proactive Sportsmed |
|---|---|
| Type | Facility |
| Speciality | Physical Therapist - Orthopedic |
| Location | 4200 6th Ave Se Ste 203, Lacey, Washington |
| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1861612335 | NPI | - | NPPES |
| 7112923 | Medicaid | WA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2251X0800X | Physical Therapist - Orthopedic | (* (Not Available)) | Primary |
| Provider Name | Michelle M Ziegler |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1376528059 PECOS PAC ID: 5597717819 Enrollment ID: I20050215000774 |
| Provider Name | Vinh Q Chung |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1245514926 PECOS PAC ID: 7618130444 Enrollment ID: I20120515000368 |
| Provider Name | Vince A Gildner |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1396746418 PECOS PAC ID: 3678566627 Enrollment ID: I20120911000779 |
| Provider Name | Megan E Dalebout |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1144639402 PECOS PAC ID: 4385968825 Enrollment ID: I20150112000038 |
| Provider Name | Nicole C Fernandez |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1679086144 PECOS PAC ID: 0345508206 Enrollment ID: I20171222000547 |
| Provider Name | Trey E Larant |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1679065965 PECOS PAC ID: 4183979958 Enrollment ID: I20180619001790 |
| Provider Name | Kindra M Mcdougall |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1205327905 PECOS PAC ID: 0840545596 Enrollment ID: I20180620001908 |
| Provider Name | Katherine R Shaw |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1558918664 PECOS PAC ID: 2264762533 Enrollment ID: I20190930001791 |
| Provider Name | Alec C Kirk |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1164058582 PECOS PAC ID: 7618395997 Enrollment ID: I20200918000617 |
| Provider Name | Madeline E Abbs |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1881325637 PECOS PAC ID: 7517349632 Enrollment ID: I20220804003572 |
| Provider Name | Catherine E Kirkman |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1346890167 PECOS PAC ID: 2062845134 Enrollment ID: I20221025002071 |
| Provider Name | Sara M Geiger |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1760188924 PECOS PAC ID: 7719347996 Enrollment ID: I20230719003104 |
| Mailing Address | Practice Location Address |
|---|---|
| Proactive Sportsmed 4200 6th Ave Se Ste 203, Lacey, WA 98503-1042 Ph: (360) 455-4448 | Proactive Sportsmed 4200 6th Ave Se Ste 203, Lacey, WA 98503-1042 Ph: (360) 455-4448 |
Dorothy Kilvington, DPT Physical Therapist Medicare: Medicare Enrolled Practice Location: 130 Marvin Rd Se Ste 203, Lacey, WA 98503 Phone: 360-456-3300 | |
Abigail Namocatcat, Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 4200 6th Ave Se, Suite 201, Lacey, WA 98503 Phone: 360-459-8311 | |
Juman Park, DPT Physical Therapist Medicare: Medicare Enrolled Practice Location: 4800 College St Se, Lacey, WA 98503 Phone: 360-486-2900 | |
Samantha Rossi Perdue, DPT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 7940 29th Ave Ne Ste 101, Lacey, WA 98516 Phone: 360-870-2473 | |
Kathleen G Jech, PT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 4770 Yelm Hwy Se, Lacey, WA 98503 Phone: 360-491-6074 Fax: 360-491-6192 | |
Michaela Jane De Groot, PT, DPT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 4800 College St Se, Lacey, WA 98503 Phone: 360-486-2900 | |
Haley Brooks, Physical Therapist Medicare: Medicare Enrolled Practice Location: 130 Marvin Rd Se Ste 203, Lacey, WA 98503 Phone: 513-763-9744 |