Pediatric Rehabilitation Associates PLLC

Primary specialty

Pediatric Rehabilitation Medicine PhysicianTaxonomy code 2081P0010X

License

MD60570885 Issued in WA

Legal business name

PEDIATRIC REHABILITATION ASSOCIATES PLLC

Practice address

1907 Cooks Hill Rd
Centralia, WA 98531-9073

Phone

(253) 268-0720

NPI assigned

Jan 25, 2017

Organization subpart

No

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

Authorized official

Name

Susan Quigley, MD

Title

MD/Owner

Phone

(206) 482-0103

Specialties & licenses 2

Addresses

Locations

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

{
    "created_epoch": "1485302400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1485302400000",
    "number": "1770020992",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "117 E LOUISA ST",
            "address_2": "#370",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981023203",
            "telephone_number": "206-329-1468"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1907 COOKS HILL RD",
            "city": "CENTRALIA",
            "state": "WA",
            "postal_code": "985319073",
            "telephone_number": "253-268-0720"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEDIATRIC REHABILITATION ASSOCIATES PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-01-25",
        "last_updated": "2017-01-25",
        "status": "A",
        "authorized_official_last_name": "QUIGLEY",
        "authorized_official_first_name": "SUSAN",
        "authorized_official_title_or_position": "MD/OWNER",
        "authorized_official_telephone_number": "206-482-0103",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2081P0010X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Medicine & Rehabilitation, Pediatric Rehabilitation Medicine",
            "state": "WA",
            "license": "MD60570885",
            "primary": true
        },
        {
            "code": "2081P0301X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Medicine & Rehabilitation, Brain Injury Medicine",
            "state": "WA",
            "license": "MD60570885",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michelle L Patton, LICSW
• Donna Pauley, CRNA
• Amy Jencina Paulson, CG61113130
• Peach Pointe Adult Family Home LLC
• Angela Pearson
• Allix Kaylyn Percival, AAC
• Briana Christine Perdue, PT
• Kenneth P Perko, MD
• Stephanie Rae Peruch
• Melissa R Peters, PT, DPT

• Pediatric Rehabilitation Medicine Physician in Centralia, WA
• Providers in Centralia, WA by specialty
• Pediatric Rehabilitation Medicine Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2017; 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.