Provider Demographics
NPI:1619164209
Name:CASCADE REHABILITATION
Entity Type:Organization
Organization Name:CASCADE REHABILITATION
Other - Org Name:COLBY REHAB
Other - Org Type:Other Name
Authorized Official - Title/Position:FINANCE DIRECTOR
Authorized Official - Prefix:MISS
Authorized Official - First Name:DEBBIE
Authorized Official - Middle Name:
Authorized Official - Last Name:BAKER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:425-806-5700
Mailing Address - Street 1:11805 N CREEK PKWY S
Mailing Address - Street 2:SUITE 113
Mailing Address - City:BOTHELL
Mailing Address - State:WA
Mailing Address - Zip Code:98011-8803
Mailing Address - Country:US
Mailing Address - Phone:425-806-5700
Mailing Address - Fax:425-806-5701
Practice Address - Street 1:3726 BROADWAY
Practice Address - Street 2:STE 104
Practice Address - City:EVERETT
Practice Address - State:WA
Practice Address - Zip Code:98201-3787
Practice Address - Country:US
Practice Address - Phone:425-252-4600
Practice Address - Fax:425-252-4477
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HEALTHFORCE PARTNERS
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-09-27
Last Update Date:2008-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAGAB12594Medicare PIN
WA4506450002Medicare NSC