Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Lake Sammamish Physical Therapy, PLLC

Organization Registered Dietitian · NPI 1740407816

Lake Sammamish Physical Therapy, PLLC is a Registered Dietitian in Issaquah, Washington. Licensed in Washington. Registered with an NPI since 2007.

Licensed in
WA
In the registry since
2007
Specialties on file
4
What do these letters mean?
PLLC — Professional limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

6520 226th Pl SE Ste 201
Issaquah, WA 98027-8969
Phone: (425) 391-5504
Fax: (425) 391-3670
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physical Therapist (primary) Taxonomy 225100000X (WA)
Registered Dietitian Taxonomy 133V00000X
Occupational Therapist Taxonomy 225X00000X
Durable Medical Equipment & Medical Supplies Taxonomy 332B00000X

Record details

NPI number1740407816
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Dwan Diaz — Credentialing Coordinator · (425) 450-9474
Other names Lake Sammamish Physical Therapy
NPI enumeratedApril 19, 2007
Last updated in NPPESNovember 27, 2020
Certification dateNovember 27, 2020
Mailing address11711 Ne 12th St Ste 3a, Bellevue, WA 98005-2461

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