MEDICARE: REAL REHAB, PLLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	174400000X	Specialist	602134577	WA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1457353609
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	REAL REHAB, PLLC

Provider Business Mailing Address
First Line	:	9725 3RD AVE NE
Second Line	:	SUITE 100
City	:	SEATTLE
State	:	WA
Zip	:	98115-2060
Country	:	US
Telephone Number	:	206-706-7500
Fax Number	:	206-706-7890

Provider Business Practice Location Address
First Line	:	9725 3RD AVE NE
Second Line	:	SUITE 100
City	:	SEATTLE
State	:	WA
Zip	:	98115-2060
Country	:	US
Telephone Number	:	206-706-7500
Fax Number	:	206-706-7890

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	MARGA CARLSON
Credential	:
Telephone Number	:	206-706-7500

Provider Enumeration Date	:	06/01/2005
Last Update Date	:	10/18/2017

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Directions to “REAL REHAB, PLLC ” Practice Location

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