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General NPI Number Information
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NPI Number | 1275488660
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Entity Type | Organization
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Legal Business Name | TEAM RALLY SPORTS PHYSICAL THERAPY P-LLC
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Dates
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Enumeration Date | 03/02/2026
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Last Update Date | 03/02/2026
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Provider Practice Location Address
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Address Line | 7588 DELAWARE LN STE 104
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City | VANCOUVER
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State | WA
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Zip | 98664-1401
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Country | US
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Telephone | 503-567-8623
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Fax |
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Provider Business Mailing Address
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Address Line | 620 SE 168TH AVE APT G28
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City | VANCOUVER
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State | WA
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Zip | 98684-8427
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Country | US
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Telephone | 360-518-9509
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | SARAH PONGON
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Credential | PT,DPT
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Telephone | 360-518-9509
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number |
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License Number State |
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