Healthcare Provider Details

I. General information

NPI: 1487601738
Provider Name (Legal Business Name): CASHMERE PHYSICAL THERAPY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/30/2006
Last Update Date: 04/04/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

203 MISSION STREET SUITE 112
CASHMERE WA
98815
US

IV. Provider business mailing address

203 MISSION STREET SUITE 112
CASHMERE WA
98815
US

V. Phone/Fax

Practice location:
  • Phone: 509-782-8818
  • Fax: 509-782-8919
Mailing address:
  • Phone: 509-782-8818
  • Fax: 509-782-8919

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number
License Number StateWA

VIII. Authorized Official

Name: LORI MONGEON
Title or Position: OFFICE MANAGER
Credential:
Phone: 509-782-8818