# PREMERE REHAB LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Infinity Rehab
- **Organization subpart:** No

## Provider details

- **NPI number:** 1194425066
- **Authorized official:** TAMMY MCCOY (CREDENTIALING SPECIALIST)
- **Authorized official phone:** (503) 496-5057

## Contact information

- **Practice address:** 4851 MAIN ST, SPRINGFIELD, OR 97478-6057
- **Practice address phone:** (503) 485-1279
- **Mailing address:** 8100 SW NYBERG ST STE 200, TUALATIN, OR 97062-8437
- **Mailing address phone:** (503) 570-3665
- **Mailing address fax:** (503) 570-9155

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 225100000X | Physical Therapist | — | NULL | Yes |
| 225100000X | Physical Therapist | — | — | Yes |
| 225X00000X | Occupational Therapist | — | NULL | — |
| 225X00000X | Occupational Therapist | — | — | — |
| 235Z00000X | Speech-Language Pathologist | — | NULL | — |
| 235Z00000X | Speech-Language Pathologist | — | — | — |

## Other

- **Enumeration date:** 03/08/2023
- **Last updated:** 03/08/2023