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Organization
PHYSICAL THERAPY & REHAB LLC
Active
Organization
PHYSICAL THERAPY & REHAB LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DAVID PAVLOVICH VERGULYANETS DPT (MEMBER)
(503) 208-4130
Entity
Organization
Contact information
Practice address
109 SE 101ST AVE, VANCOUVER, WA 98664-3907
(503) 208-4130
(503) 961-1228
Mailing address
808 SE CHKALOV DR STE 3 #199, VANCOUVER, WA 98683
(503) 208-4130
(503) 961-1228
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
261QP2000X
Physical Therapy Clinic/Center
—
—
261QR0400X
Rehabilitation Clinic/Center
—
—
Other
Enumeration date
01/22/2024
Last updated
11/28/2025
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