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General NPI Number Information
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NPI Number | 1124209838
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Entity Type | Organization
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Legal Business Name | COLUMBIA REHAB AND PAIN INC
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Dates
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Enumeration Date | 11/21/2007
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Last Update Date | 12/15/2010
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Provider Practice Location Address
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Address Line | 6917 W GRANDRIDGE BLVD STE B
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City | KENNEWICK
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State | WA
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Zip | 99336
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Country | US
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Telephone | 509-627-2848
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Fax | 509-627-2849
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Provider Business Mailing Address
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Address Line | 6917 W GRANDRIDGE BLVD STE B
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City | KENNEWICK
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State | WA
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Zip | 99336
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Country | US
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Telephone | 509-627-2848
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Fax | 509-627-2849
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Authorized Official
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Title or Position | PHYSICIAN
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Name | MRS. JEAN YOU
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Credential | MD
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Telephone | 509-627-2848
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225400000X
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Taxonomy Name | Rehabilitation Practitioner
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License Number | MD00041323
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License Number State | WA
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