Healthcare Provider Details

I. General information

NPI: 1679969265
Provider Name (Legal Business Name): REBECCA KATHRYN SAHADI PT, DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: REBECCA KATHRYN WEICHEL PT, DPT

II. Dates (important events)

Enumeration Date: 04/09/2015
Last Update Date: 03/12/2020
Certification Date: 03/12/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2500 NE NEFF RD
BEND OR
97701-6015
US

IV. Provider business mailing address

2500 NE NEFF RD CARDIAC REHABILITATION - HEART AND LUNG CENTER
BEND OR
97701-6015
US

V. Phone/Fax

Practice location:
  • Phone: 541-706-2696
  • Fax: 541-706-2764
Mailing address:
  • Phone: 541-706-2696
  • Fax: 541-706-2764

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number013419
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number63199
License Number StateOR

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: