Pacific Rehabilitation & Sports Medicine Inc

Primary specialty

Physical Therapy Clinic/CenterTaxonomy code 261QP2000X

Legal business name

PACIFIC REHABILITATION & SPORTS MEDICINE INC

Practice address

17910 Talbot Rd S
#101
Renton, WA 98055

Phone

(425) 235-5588

Fax

(425) 687-9410

NPI assigned

Jun 18, 2006

Reactivated

Feb 29, 2008

Last updated

Feb 29, 2008By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Michael E Tarvin

Title

Vice President

Phone

(717) 975-4503

Specialties & licenses 2

Addresses

Tax ID family

Pacific Rehabilitation Sports Medicine Inc2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Pacific Rehabilitation & Sports Medicine Inc

  • Rehabilitation Clinic/Center
  • Portland, OR
  • NPI 1144282310
  NPD tax ID

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1150588800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1204243200000",
    "number": "1053356717",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4716 OLD GETTYSBURG RD",
            "city": "MECHANICSBURG",
            "state": "PA",
            "postal_code": "17055",
            "telephone_number": "717-975-4503",
            "fax_number": "717-975-9781"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17910 TALBOT RD S",
            "address_2": "#101",
            "city": "RENTON",
            "state": "WA",
            "postal_code": "98055",
            "telephone_number": "425-235-5588",
            "fax_number": "425-687-9410"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PACIFIC REHABILITATION & SPORTS MEDICINE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-18",
        "last_updated": "2008-02-29",
        "deactivation_date": "2008-01-08",
        "reactivation_date": "2008-02-29",
        "status": "A",
        "authorized_official_last_name": "TARVIN",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "717-975-4503"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "WA",
            "license": null,
            "primary": true
        },
        {
            "code": "261QR0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Linda L Overland-Smith, RN
• Stephanie Marie Owens, OT
• Pacific Chiropractic, LLC
• Pacific Medical, Inc. (Pacific Medical Prosthetics & Orthotics)
• Pacific Northwest Family Care
• Pacific Retina Center PLLC
• Pacific Rheumatology Associates Inc PS
• Heather Paciotti
• Paolo A Paciucci, M.D.
• Pacmed Clinics

• Physical Therapy Clinic/Center in Renton, WA
• Providers in Renton, WA by specialty
• Physical Therapy Clinic/Center in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 29, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.