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

Peter Kolodychuk

Individual provider Physical Therapist · NPI 1215545165

Peter Kolodychuk is a Physical Therapist in Private Practice in Mount Vernon, Washington. Qualified in 2020, 6 years ago. Practices with Northwest Center for Sports Medicine and Physical Therapy Inc, a 87-clinician group and accepts Medicare assignment.

Years since qualifying
6
In the registry since
2020
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Practice location Address checks out

2116 E Section St Ste B17
Mount Vernon, WA 98274-9124
Phone: (360) 588-4241
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physical Therapist (primary) Taxonomy 225100000X

Record details

NPI number1215545165
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedJuly 16, 2020
Last updated in NPPESJuly 16, 2020
Certification dateJuly 16, 2020
Mailing address1200 Corporate Dr Ste 400, Birmingham, AL 35242-5424

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICAL THERAPIST IN PRIVATE PRACTICE
Medical schoolOTHER
Graduated 2020 (6 years in practice)
Group practice Northwest Center For Sports Medicine And Physical Therapy Inc — 87 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Other providers in Mount Vernon