Healthcare Provider Details

I. General information

NPI: 1790089415
Provider Name (Legal Business Name): WESTON REHABILITATION WASHINGTON LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/10/2011
Last Update Date: 01/10/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12806 BOTHELL EVERETT HWY
EVERETT WA
98208-6692
US

IV. Provider business mailing address

3131 ELLIOTT AVE
SEATTLE WA
98121-1031
US

V. Phone/Fax

Practice location:
  • Phone: 425-338-3227
  • Fax:
Mailing address:
  • Phone: 206-298-2909
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number State

VIII. Authorized Official

Name: CHRISTOPHER R. GUAY
Title or Position: CEO
Credential:
Phone: 603-821-1827