Provider Demographics
NPI:1093773368
Name:REHM, LISA MARIE (PT, MSPT)
Entity Type:Individual
Prefix:
First Name:LISA
Middle Name:MARIE
Last Name:REHM
Suffix:
Gender:F
Credentials:PT, MSPT
Other - Prefix:
Other - First Name:LISA
Other - Middle Name:MARIE
Other - Last Name:DIDONE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT, MSPT
Mailing Address - Street 1:1417 116TH AVE NE
Mailing Address - Street 2:SUITE 110
Mailing Address - City:BELLEVUE
Mailing Address - State:WA
Mailing Address - Zip Code:98004-3821
Mailing Address - Country:US
Mailing Address - Phone:425-688-5902
Mailing Address - Fax:425-688-5912
Practice Address - Street 1:1417 116TH AVE NE
Practice Address - Street 2:SUITE 110
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98004-3821
Practice Address - Country:US
Practice Address - Phone:425-688-5902
Practice Address - Fax:425-688-5912
Is Sole Proprietor?:No
Enumeration Date:2006-05-03
Last Update Date:2013-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPT00007423225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAAB39059Medicare ID - Type Unspecified