# PROVAIL

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1871857946
- **Authorized official:** MICHAEL HATZENBELER (CEO)
- **Authorized official phone:** (206) 826-1044

## Contact information

- **Practice address:** 12550 AURORA AVE N, SEATTLE, WA 98133-8036
- **Practice address phone:** (206) 363-7303
- **Mailing address:** 12550 AURORA AVE N, SEATTLE, WA 98133-8036
- **Mailing address phone:** (206) 363-7303

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QR0400X | Rehabilitation Clinic/Center | OT60281347 | WA | Yes |

## Other

- **Enumeration date:** 07/03/2012
- **Last updated:** 07/03/2012