Provider Demographics
NPI:1710949086
Name:ST LUKE'S REHABILITATION INSTITUTE
Entity Type:Organization
Organization Name:ST LUKE'S REHABILITATION INSTITUTE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXERCISE PHYSIOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:LEONA
Authorized Official - Middle Name:KAY
Authorized Official - Last Name:BUDDE
Authorized Official - Suffix:
Authorized Official - Credentials:BS
Authorized Official - Phone:509-473-6013
Mailing Address - Street 1:39424 S BRUCE RD
Mailing Address - Street 2:
Mailing Address - City:ROSALIA
Mailing Address - State:WA
Mailing Address - Zip Code:99170-9714
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:39424 S BRUCE RD
Practice Address - Street 2:
Practice Address - City:ROSALIA
Practice Address - State:WA
Practice Address - Zip Code:99170-9714
Practice Address - Country:US
Practice Address - Phone:509-523-5232
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-03
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225CA2400XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation CounselorAssistive Technology PractitionerGroup - Multi-Specialty