Healthcare Provider Details

I. General information

NPI: 1477582641
Provider Name (Legal Business Name): PACIFIC BALANCE AND REHABILITATION CLINIC PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/01/2006
Last Update Date: 10/29/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 MERCER ST SUITE 302
SEATTLE WA
98109-4650
US

IV. Provider business mailing address

PO BOX 9940
SEATTLE WA
98109-0940
US

V. Phone/Fax

Practice location:
  • Phone: 206-448-1906
  • Fax:
Mailing address:
  • Phone: 206-448-1906
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MR. CHRISTOPHER THERON MORROW
Title or Position: PRINCIPAL
Credential: PT
Phone: 206-448-1906