Provider Demographics
NPI:1700959749
Name:RAINBOW REHAB,PLLC
Entity Type:Organization
Organization Name:RAINBOW REHAB,PLLC
Other - Org Name:MARSHA K HILLER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARSHA
Authorized Official - Middle Name:K
Authorized Official - Last Name:HILLER
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:253-589-9600
Mailing Address - Street 1:8907 GRAVELLY LAKE DR SW
Mailing Address - Street 2:STE A
Mailing Address - City:LAKEWOOD
Mailing Address - State:WA
Mailing Address - Zip Code:98499
Mailing Address - Country:US
Mailing Address - Phone:253-589-9600
Mailing Address - Fax:253-589-9610
Practice Address - Street 1:8907 GRAVELLY LAKE DR SW
Practice Address - Street 2:STE A
Practice Address - City:LAKEWOOD
Practice Address - State:WA
Practice Address - Zip Code:98499
Practice Address - Country:US
Practice Address - Phone:253-589-9600
Practice Address - Fax:253-589-9610
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-16
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPT00005135225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA7133358Medicaid
WA11550913OtherCAQH
WA0205655OtherL&I
WA7133358Medicaid