WALLA WALLA PHYSICAL THERAPY CENTER APS – Physical Therapist, NPI 1477574606

WALLA WALLA PHYSICAL THERAPY CENTER APS is a healthcare provider. based in Walla walla, Washington. specializing in Physical Therapist. The organization holds a License No. 601 755 670 (WA). The NPI Number for WALLA WALLA PHYSICAL THERAPY CENTER APS is 1477574606

Main info

Organization
Name
WALLA WALLA PHYSICAL THERAPY CENTER APS
NPI
1477574606
Phone
(509) 522-0114
Address
275 W TIETAN ST
Authorized Official
MICHAEL J CLARK PHYSICAL THERAPIST/OWNER PT
Enumeration Date
22 July 2006
Deactivation Date
2 June 2023
Reactivation Date
22 June 2023
Last Update Date
22 June 2023
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience62
Completeness75
Years active:19State licenses:1Digital endpointsOther names

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Provider Addresses for WALLA WALLA PHYSICAL THERAPY CENTER APS

  • West Tietan Street, Walla Walla, Walla Walla County, Washington, 99362-5024, United States

    WALLA WALLA, WA 993624363

    Phone: (509) 522-0114

    Fax: (509) 522-9868

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2004-03-24

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
O20040324001688OClinic/Group PracticeWATBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 99362)

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Reviews

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Frequently asked questions

Can I use this page to confirm WALLA WALLA PHYSICAL THERAPY CENTER APS's NPI?
Yes. WALLA WALLA PHYSICAL THERAPY CENTER APS is listed with NPI 1477574606 in the public NPI dataset.
Does the file indicate WALLA WALLA PHYSICAL THERAPY CENTER APS is practicing under active NPI?
Directory data currently reports WALLA WALLA PHYSICAL THERAPY CENTER APS as active.
What is WALLA WALLA PHYSICAL THERAPY CENTER APS's specialty?
The listing groups WALLA WALLA PHYSICAL THERAPY CENTER APS with Physical Therapist. Clinical services aligned with this taxonomy classification.
What area does WALLA WALLA PHYSICAL THERAPY CENTER APS serve?
WALLA WALLA PHYSICAL THERAPY CENTER APS's listing highlights Walla Walla, Washington; more addresses can appear in NPPES.
Is the information about WALLA WALLA PHYSICAL THERAPY CENTER APS up to date?
Data updates when providers file changes in NPPES — treat critical facts as "verify if unsure."

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