Provider Demographics
NPI:1689866238
Name:ONCOLOGY REHABILITATION SPECIALISTS, INC.
Entity Type:Organization
Organization Name:ONCOLOGY REHABILITATION SPECIALISTS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICAL THERAPIST/OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:CAROL
Authorized Official - Middle Name:
Authorized Official - Last Name:EDDY
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:425-467-7105
Mailing Address - Street 1:1239 120TH AVE NE
Mailing Address - Street 2:SUITE E
Mailing Address - City:BELLEVUE
Mailing Address - State:WA
Mailing Address - Zip Code:98005-2133
Mailing Address - Country:US
Mailing Address - Phone:425-467-7105
Mailing Address - Fax:425-467-7135
Practice Address - Street 1:1239 120TH AVE NE
Practice Address - Street 2:SUITE E
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98005-2133
Practice Address - Country:US
Practice Address - Phone:425-467-7105
Practice Address - Fax:425-467-7135
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-16
Last Update Date:2010-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAAB36882Medicare PIN