Provider Demographics
NPI:1851465447
Name:STROM, RODNEY W (PT, CHT)
Entity Type:Individual
Prefix:
First Name:RODNEY
Middle Name:W
Last Name:STROM
Suffix:
Gender:M
Credentials:PT, CHT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13102 E MISSION AVE
Mailing Address - Street 2:
Mailing Address - City:SPOKANE VALLEY
Mailing Address - State:WA
Mailing Address - Zip Code:99216-2710
Mailing Address - Country:US
Mailing Address - Phone:509-928-6220
Mailing Address - Fax:509-928-7597
Practice Address - Street 1:13102 E MISSION AVE
Practice Address - Street 2:
Practice Address - City:SPOKANE VALLEY
Practice Address - State:WA
Practice Address - Zip Code:99216-2710
Practice Address - Country:US
Practice Address - Phone:509-928-6220
Practice Address - Fax:509-928-7597
Is Sole Proprietor?:No
Enumeration Date:2006-11-17
Last Update Date:2015-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPT00002878225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAG8800296OtherMEDICARE GROUP NUMBER
WA8855154Medicare ID - Type UnspecifiedPHYSICAL THERAPIST