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General NPI Number Information
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NPI Number | 1194057307
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Entity Type | Organization
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Legal Business Name | INFINTIY REHAB
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Dates
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Enumeration Date | 02/12/2010
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Last Update Date | 02/12/2010
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Provider Practice Location Address
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Address Line | 10901 176TH CIR NE
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City | REDMOND
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State | WA
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Zip | 98052-7218
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Country | US
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Telephone | 425-556-8241
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Fax |
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Provider Business Mailing Address
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Address Line | 14253 93RD CT NE
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City | BOTHELL
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State | WA
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Zip | 98011-5150
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Country | US
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Telephone | 425-821-4165
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Fax |
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Authorized Official
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Title or Position | OCCUPATIONAL THERAPIST
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Name | MRS. CHRISTY LEE JACOBS
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Credential | BACHLEOR ODF SCIENCE
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Telephone | 425-821-4165
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 310400000X
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Taxonomy Name | Assisted Living Facility
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License Number | OT00000142
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License Number State | WA
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