Provider Demographics
NPI:1518246495
Name:OLYMPIC REHAB ASSOCIATES, INC
Entity Type:Organization
Organization Name:OLYMPIC REHAB ASSOCIATES, INC
Other - Org Name:UPTOWN PHYSICAL THERAPY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT, THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:PAUL
Authorized Official - Last Name:PEREZ
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:951-205-0885
Mailing Address - Street 1:260 FAWN LN
Mailing Address - Street 2:
Mailing Address - City:SEQUIM
Mailing Address - State:WA
Mailing Address - Zip Code:98382-3852
Mailing Address - Country:US
Mailing Address - Phone:360-681-2825
Mailing Address - Fax:360-385-4395
Practice Address - Street 1:1215 LAWRENCE ST
Practice Address - Street 2:101
Practice Address - City:PORT TOWNSEND
Practice Address - State:WA
Practice Address - Zip Code:98368-6559
Practice Address - Country:US
Practice Address - Phone:360-385-1035
Practice Address - Fax:360-385-4395
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-08-10
Last Update Date:2016-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPT60132077261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy