# PACIFIC REHABILITATION & SPORTS MEDICINE INC

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

## Provider details

- **NPI number:** 1952350688
- **Authorized official:** MICHAEL TARVIN (VICE PRESIDENT)
- **Authorized official phone:** (717) 975-4503

## Contact information

- **Practice address:** 12500 AURORA AVE N, STE C, SEATTLE, WA 98133-1518
- **Practice address phone:** (206) 524-6916
- **Mailing address:** 12500 AURORA AVE N, STE C, SEATTLE, WA 98133-1518
- **Mailing address phone:** (206) 524-6916

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QR0400X | Rehabilitation Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 05/09/2006
- **Last updated:** 03/11/2008