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Organization
PREMERE REHAB LLC
Active
Organization
PREMERE REHAB LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LAURA CANTRELL (DIRECTOR OF OUTPATIENT)
(360) 901-8111
Entity
Organization
Contact information
Practice address
3801 SUMMITVIEW AVE, YAKIMA, WA 98902-2794
(509) 853-3120
Mailing address
25117 SW PARKWAY AVE, SUITE D, WILSONVILLE, OR 97070-9697
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
225X00000X
Occupational Therapist
—
—
235Z00000X
Speech-Language Pathologist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
G8899725
PTAN
WA
Enumeration date
03/10/2011
Last updated
01/02/2013
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