1659446383 NPI number — INDEPENDENT THERAPY SERVICES INC

Table of content: (NPI 1659446383)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1659446383 NPI number — INDEPENDENT THERAPY SERVICES INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
INDEPENDENT THERAPY SERVICES INC
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:
1659446383
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
10820 SUMMITVIEW RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
YAKIMA
Provider Business Mailing Address State Name:
WA
Provider Business Mailing Address Postal Code:
98908
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
509-966-4510
Provider Business Mailing Address Fax Number:
509-453-0964

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
901 SUMMITVIEW AVE
Provider Second Line Business Practice Location Address:
SUITE 210 H
Provider Business Practice Location Address City Name:
YAKIMA
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98902
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-248-3320
Provider Business Practice Location Address Fax Number:
509-453-0964
Provider Enumeration Date:
11/21/2006

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
FRANCIS
Authorized Official First Name:
OSCAR
Authorized Official Middle Name:
MICHAEL
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
509-966-4510

Provider Taxonomy Codes

  • Taxonomy code: 225100000X , with the licence number:  PT00003324 , registered in the state of WA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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