Provider Demographics
NPI:1164539052
Name:REIMER, RONN L (PHYSICAL THERAPIST)
Entity Type:Individual
Prefix:MR
First Name:RONN
Middle Name:L
Last Name:REIMER
Suffix:
Gender:M
Credentials:PHYSICAL THERAPIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13917 50TH DR SE
Mailing Address - Street 2:
Mailing Address - City:SNOHOMISH
Mailing Address - State:WA
Mailing Address - Zip Code:98296-7606
Mailing Address - Country:US
Mailing Address - Phone:425-485-5444
Mailing Address - Fax:425-485-5588
Practice Address - Street 1:18920 BOTHELL WAY NE
Practice Address - Street 2:#102
Practice Address - City:BOTHELL
Practice Address - State:WA
Practice Address - Zip Code:98011-1981
Practice Address - Country:US
Practice Address - Phone:425-485-5444
Practice Address - Fax:425-485-5588
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPT000040022251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA8394173Medicaid
WAAB35570Medicare ID - Type Unspecified