Healthcare Provider Details

I. General information

NPI: 1942470232
Provider Name (Legal Business Name): PACIFIC MEDICAL REHABILITATION, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/03/2008
Last Update Date: 01/07/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4540 CORDATA PKWY SUITE 101
BELLINGHAM WA
98226-8059
US

IV. Provider business mailing address

PO BOX 30676
BELLINGHAM WA
98228-2676
US

V. Phone/Fax

Practice location:
  • Phone: 360-543-5250
  • Fax: 360-543-5251
Mailing address:
  • Phone: 360-543-5250
  • Fax: 360-543-5251

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM2500X
TaxonomyMedical Specialty Clinic/Center
License NumberMD00039814
License Number StateWA

VIII. Authorized Official

Name: DR. JIMMY YI CUI
Title or Position: MEMBER
Credential: MD
Phone: 360-543-5250