Provider Demographics
NPI:1063827772
Name:RESCARE REHAB WITHOUT WALLS OUTPATIENT CENTER
Entity Type:Organization
Organization Name:RESCARE REHAB WITHOUT WALLS OUTPATIENT CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:AMY
Authorized Official - Middle Name:
Authorized Official - Last Name:MEYERS
Authorized Official - Suffix:
Authorized Official - Credentials:OTR/L
Authorized Official - Phone:425-672-2716
Mailing Address - Street 1:6912 220TH ST SW
Mailing Address - Street 2:SUITE 200
Mailing Address - City:MOUNTLAKE TERRACE
Mailing Address - State:WA
Mailing Address - Zip Code:98043-2169
Mailing Address - Country:US
Mailing Address - Phone:425-672-2716
Mailing Address - Fax:
Practice Address - Street 1:6912 220TH ST SW
Practice Address - Street 2:SUITE 200
Practice Address - City:MOUNTLAKE TERRACE
Practice Address - State:WA
Practice Address - Zip Code:98043-2169
Practice Address - Country:US
Practice Address - Phone:425-672-2716
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-06-23
Last Update Date:2014-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAOT60437671261QR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0400XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation