Provider Demographics
NPI:1396959565
Name:FIRST REHABILITATION & PHYSICAL THERAPY, INC.
Entity type:Organization
Organization Name:FIRST REHABILITATION & PHYSICAL THERAPY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:NENA
Authorized Official - Middle Name:A
Authorized Official - Last Name:SUENO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:360-438-1460
Mailing Address - Street 1:PO BOX 1068
Mailing Address - Street 2:
Mailing Address - City:OLYMPIA
Mailing Address - State:WA
Mailing Address - Zip Code:98507-1068
Mailing Address - Country:US
Mailing Address - Phone:360-438-1460
Mailing Address - Fax:360-438-1683
Practice Address - Street 1:3775 MARTIN WAY E STE A
Practice Address - Street 2:
Practice Address - City:OLYMPIA
Practice Address - State:WA
Practice Address - Zip Code:98506-5007
Practice Address - Country:US
Practice Address - Phone:360-438-1460
Practice Address - Fax:360-438-1683
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-09
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA7025273Medicaid
WA30560OtherLABOR & INDUSTRIES
WA7025273Medicaid