Provider Demographics
NPI:1134537780
Name:INFINITY REHAB
Entity type:Organization
Organization Name:INFINITY REHAB
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OCCUPATIONAL THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:LUCILYN
Authorized Official - Middle Name:CASTRO
Authorized Official - Last Name:LUMIO
Authorized Official - Suffix:
Authorized Official - Credentials:OTR/L
Authorized Official - Phone:425-244-2762
Mailing Address - Street 1:17517 52ND AVE W # B-2
Mailing Address - Street 2:
Mailing Address - City:LYNNWOOD
Mailing Address - State:WA
Mailing Address - Zip Code:98037-5701
Mailing Address - Country:US
Mailing Address - Phone:425-244-2762
Mailing Address - Fax:
Practice Address - Street 1:17517 52ND AVE W # B-2
Practice Address - Street 2:
Practice Address - City:LYNNWOOD
Practice Address - State:WA
Practice Address - Zip Code:98037-5701
Practice Address - Country:US
Practice Address - Phone:425-244-2762
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-07-28
Last Update Date:2014-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA00004208261QX0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QX0100XAmbulatory Health Care FacilitiesClinic/CenterOccupational Medicine