Healthcare Provider Details

I. General information

NPI: 1841369048
Provider Name (Legal Business Name): ACHIEVE REHABILITATION, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/06/2006
Last Update Date: 08/06/2022
Certification Date: 08/05/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1818 S UNION AVE STE 1B
TACOMA WA
98405-1953
US

IV. Provider business mailing address

1818 S UNION AVE STE 1B
TACOMA WA
98405-1953
US

V. Phone/Fax

Practice location:
  • Phone: 253-627-7012
  • Fax: 253-627-7014
Mailing address:
  • Phone: 253-627-7012
  • Fax: 253-627-7014

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License NumberPT 8422
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number StateNULL

VIII. Authorized Official

Name: MR. KEITH MICHAEL REAGAN
Title or Position: OWNER
Credential: P.T.
Phone: 253-627-7012