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General NPI Number Information
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NPI Number | 1649641572
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Entity Type | Organization
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Legal Business Name | INTEGRATED REHABILITATION GROUP, PC
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Dates
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Enumeration Date | 10/19/2015
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Last Update Date | 12/28/2023
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Provider Practice Location Address
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Address Line | 514 N 85TH ST
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City | SEATTLE
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State | WA
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Zip | 98103-3721
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Country | US
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Telephone | 206-900-8883
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Fax | 206-962-3792
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Provider Business Mailing Address
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Address Line | 4220 132ND ST SE SUITE 101
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City | MILL CREEK
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State | WA
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Zip | 98012-8999
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Country | US
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Telephone | 425-357-9380
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Fax | 425-357-9382
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Authorized Official
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Title or Position | OWNER
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Name | MICHAEL S OKELLEY
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Credential |
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Telephone | 425-357-9380
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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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Taxonomy #2
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number |
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License Number State |
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Taxonomy #3
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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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