Healthcare Provider Details
I. General information
NPI: 1417144007
Provider Name (Legal Business Name): CASCADE REHABILITATION, LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 09/27/2007
Last Update Date: 12/07/2009
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
3710 168TH ST NE PILCHUCK PLAZA, BUILDING A102,
ARLINGTON WA
98223-8462
US
IV. Provider business mailing address
11805 N CREEK PKWY S SUITE 113
BOTHELL WA
98011-8803
US
V. Phone/Fax
- Phone: 360-658-8100
- Fax: 360-658-0508
- Phone: 425-806-5700
- Fax: 425-806-5701
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 225100000X |
| Taxonomy | Physical Therapist |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MISS
DEBBIE
BAKER
Title or Position: FINANCE DIRECTOR
Credential:
Phone: 425-806-5700