1255409850 NPI number — CENTRAL HAND THERAPY, PC

Table of content: (NPI 1255409850)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1255409850 NPI number — CENTRAL HAND THERAPY, PC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CENTRAL HAND THERAPY, PC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1255409850
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/30/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 11009
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
OLYMPIA
Provider Business Mailing Address State Name:
WA
Provider Business Mailing Address Postal Code:
98508-1009
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
360-352-2037
Provider Business Mailing Address Fax Number:
360-352-0637

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
100 E JACKSON AVE
Provider Second Line Business Practice Location Address:
SUITE 200
Provider Business Practice Location Address City Name:
ELLENSBURG
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98926
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-962-1132
Provider Business Practice Location Address Fax Number:
866-365-5203
Provider Enumeration Date:
12/01/2006

Additional Information

Authorized Official

Authorized Official Last Name:
RATTRAY
Authorized Official First Name:
JARED
Authorized Official Middle Name:
RYAN
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
509-962-1132

Provider Taxonomy Codes

  • Taxonomy code: 208100000X , with the licence number:  OT00003293 , registered in the state of WA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 208100000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 1255409850 . This is a "NIP NUMBER (GROUP)" identifier . This identifiers is of the category "OTHER".
  • Identifier: DA9136 . This is a "MEDICARE RAILROAD" identifier . This identifiers is of the category "OTHER".




Copyright © 2007-2024 www.npivalidator.com