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General NPI Number Information
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NPI Number | 1255773362
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Entity Type | Organization
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Legal Business Name | SALISH SEA PHYSICAL THERAPY LLC
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Dates
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Enumeration Date | 07/18/2013
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Last Update Date | 06/23/2020
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Provider Practice Location Address
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Address Line | 6441 HARDING AVE
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City | CLINTON
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State | WA
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Zip | 98236-9600
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Country | US
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Telephone | 360-221-5432
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Fax | 360-221-5434
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Provider Business Mailing Address
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Address Line | 6441 HARDING AVE
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City | CLINTON
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State | WA
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Zip | 98236-9600
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Country | US
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Telephone | 360-221-5432
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Fax | 360-221-5434
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Authorized Official
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Title or Position | OWNER
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Name | IAN D RODRIGUEZ
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Credential |
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Telephone | 360-221-5432
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number |
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License Number State |
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