Revitalize Physical Therapy PLLC
NPI 1114894417 · Physical Therapy Clinic/Center · Vancouver, WA
Enrolled with Medicare as Part B Supplier - Physical/Occupational Therapy Group in Private Practice · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Revitalize Physical Therapy PLLC is a Physical Therapy Clinic/Center organization in Vancouver, WA (NPI 1114894417).
Provider details
- NPI number
- 1114894417
- Entity type
- Organization
- Primary specialty
- Physical Therapy Clinic/CenterAmbulatory Health Care Facilities
- Organization subpart
- No
- Authorized official
- Ryan Iggulden, Owner(360) 448-3544
Specialties & taxonomies
Ambulatory Health Care Facilities
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
Under 1 yr in registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Mailing address
Registry dates
- Enumerated
- 2025-10-21
- Last updated
- 2025-10-21
- Certified
- 2025-10-21
Frequently asked questions
- What is Revitalize Physical Therapy PLLC's NPI number?
- Revitalize Physical Therapy PLLC's National Provider Identifier (NPI) is 1114894417, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Revitalize Physical Therapy PLLC?
- Revitalize Physical Therapy PLLC is classified in the NPPES registry as Physical Therapy Clinic/Center (Ambulatory Health Care Facilities).
- Where is Revitalize Physical Therapy PLLC located?
- Revitalize Physical Therapy PLLC's practice location on file with NPPES is 2102 E Mcloughlin Blvd, Vancouver, WA 98661-4130.
- What is Revitalize Physical Therapy PLLC's phone number?
- The practice phone number listed in the NPPES registry for Revitalize Physical Therapy PLLC is (360) 448-3544.
- Does Revitalize Physical Therapy PLLC accept Medicare?
- Revitalize Physical Therapy PLLC is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.
- Who is the authorized official for Revitalize Physical Therapy PLLC?
- The authorized official listed on Revitalize Physical Therapy PLLC's NPPES record is Ryan Iggulden, Owner. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Revitalize Physical Therapy PLLC's NPI active?
- Yes — Revitalize Physical Therapy PLLC's NPI (1114894417) is active in the NPPES registry as of the last update on 2025-10-21.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.