Healthcare Provider Details

I. General information

NPI: 1073349254
Provider Name (Legal Business Name): SNF PHYSIATRY SERVICES WA PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/12/2024
Last Update Date: 09/12/2024
Certification Date: 09/12/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

720 SENECA ST
SEATTLE WA
98101-2764
US

IV. Provider business mailing address

185 ROUTE 70 STE 305
TOMS RIVER NJ
08755-0936
US

V. Phone/Fax

Practice location:
  • Phone: 732-813-0799
  • Fax:
Mailing address:
  • Phone: 732-813-0799
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License Number
License Number State

VIII. Authorized Official

Name: JAMES JEFFREY COLE
Title or Position: OWNER
Credential: MD
Phone: 732-813-0799