Healthcare Provider Details

I. General information

NPI: 1093395360
Provider Name (Legal Business Name): REHAB EXPERTS AND CONSULTING LLC/ PHYSIO GROUP LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/12/2021
Last Update Date: 04/12/2021
Certification Date: 04/12/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17526 163RD PLACE SE
RENTON WA
98058-9131
US

IV. Provider business mailing address

17526 163RD PL SE
RENTON WA
98058-9131
US

V. Phone/Fax

Practice location:
  • Phone: 425-318-0551
  • Fax:
Mailing address:
  • Phone: 425-318-0551
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2251E1200X
TaxonomyErgonomics Physical Therapist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: DR. NANCY L RICKERSON
Title or Position: ADMINISTRATIVE DIRECTOR
Credential: PH.D. , OTR/L
Phone: 425-879-3403