Organization
PACIFIC REHABILITATION & SPORTS MEDICINE INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL TARVIN (VICE PRESIDENT)
(717) 972-1100
Entity
Organization
Contact information
Practice address
2330 NW FLANDERS ST, STE 101, PORTLAND, OR 97210-3442
(503) 228-8575
Mailing address
2330 NW FLANDERS ST, STE 101, PORTLAND, OR 97210-3442
(503) 228-8575
Taxonomy
Speciality
Code
Description
License number
State
261QR0400X
Rehabilitation Clinic/Center
Primary
—
—
Other
Enumeration date
04/04/2006
Last updated
09/01/2010
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