Healthcare Provider Details

I. General information

NPI: 1902909161
Provider Name (Legal Business Name): RHONDA CATHERINE HURT PT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: RHONDA CATHERINE GRISHAM,SMITH

II. Dates (important events)

Enumeration Date: 09/06/2006
Last Update Date: 07/16/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2211 E MILL PLAIN BLVD
VANCOUVER WA
98661-4329
US

IV. Provider business mailing address

2211 E MILL PLAIN BLVD
VANCOUVER WA
98661-4329
US

V. Phone/Fax

Practice location:
  • Phone: 360-418-6001
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number4313
License Number StateOR
# 2
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT00009706
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: