Physical Therapy & Rehab LLC

Primary specialty

Physical TherapistTaxonomy code 225100000X

Legal business name

PHYSICAL THERAPY & REHAB LLC

Practice address

109 SE 101St Ave
Vancouver, WA 98664-3907

Phone

(503) 208-4130

Fax

(503) 961-1228

NPI assigned

Jan 22, 2024

Last updated

Nov 28, 2025By 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

David Pavlovich Vergulyanets, DPTNPI 1215716170

Title

Member

Phone

(503) 208-4130

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in WA

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• David Pavlovich Vergulyanets, PT, DPT.

  • Physical Therapist
  • Vancouver, WA
  • NPI 1215716170
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1705881600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1764288000000",
    "number": "1437910049",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "808 SE CHKALOV DR STE 3 #199",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "98683",
            "telephone_number": "503-208-4130",
            "fax_number": "503-961-1228"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "109 SE 101ST AVE",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986643907",
            "telephone_number": "503-208-4130",
            "fax_number": "503-961-1228"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHYSICAL THERAPY & REHAB LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-01-22",
        "last_updated": "2025-11-28",
        "certification_date": "2025-11-28",
        "status": "A",
        "authorized_official_last_name": "VERGULYANETS",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "PAVLOVICH",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "503-208-4130",
        "authorized_official_credential": "DPT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QR0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Tai Phong, RNBSN
• Brigid Marie-Crotty Piccolotti, MS, CCC-SLP
• Pickens Family Dentistry
• Drue Pickens, D.D.S.
• Paul Douglas Pickering, M.D.
• Cami Rae Pickett, BA

• Physical Therapist in Vancouver, WA
• Providers in Vancouver, WA by specialty
• Physical Therapist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 28, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.