1982792016 NPI number — RAINIER REHABILITATION ASSOCIATES, PLLC

Table of content: (NPI 1982792016)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1982792016 NPI number — RAINIER REHABILITATION ASSOCIATES, PLLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
RAINIER REHABILITATION ASSOCIATES, PLLC
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:
1982792016
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/08/2014
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
8012 112TH STREET CT E
Provider Second Line Business Mailing Address:
# 120
Provider Business Mailing Address City Name:
PUYALLUP
Provider Business Mailing Address State Name:
WA
Provider Business Mailing Address Postal Code:
98373-7856
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
253-286-2710
Provider Business Mailing Address Fax Number:
253-286-2719

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
8012 112TH ST CT E
Provider Second Line Business Practice Location Address:
# 120
Provider Business Practice Location Address City Name:
PUYALLUP
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98373-7856
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
253-286-2710
Provider Business Practice Location Address Fax Number:
253-286-2719
Provider Enumeration Date:
10/11/2006

Additional Information

Authorized Official

Authorized Official Last Name:
KUHN
Authorized Official First Name:
DENISE
Authorized Official Middle Name:
Authorized Official Title or Position:
MANAGER
Authorized Official Telephone Number:
253-286-2710

Provider Taxonomy Codes

  • Taxonomy code: 208100000X , with the licence number:  602055728 , 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)

  • Identifier: 135918 . This is a "LABOR AND INDUSTRIES" identifier , issued by the state of ( WA ) . This identifiers is of the category "OTHER".
  • Identifier: 479445001 . This is a "GROUP HEALTH" identifier , issued by the state of ( WA ) . This identifiers is of the category "OTHER".
  • Identifier: 193479400 . This is a "FEDERAL WORKERS COMP" identifier . This identifiers is of the category "OTHER".
  • Identifier: 8927715 . This is a "CRIME VICTIMS" identifier , issued by the state of ( WA ) . This identifiers is of the category "OTHER".
  • Identifier: 7102072 , issued by the state of ( WA ) . This identifiers is of the category "MEDICAID".
  • Identifier: RA6740 . This is a "REGENCE" identifier , issued by the state of ( WA ) . This identifiers is of the category "OTHER".




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