Organization
CASCADE SPORT & SPINE REHABILITATION INC PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHIRLEY ANN GALLANGER (OFFICE MANAGER)
(360) 748-1580
Entity
Organization
Contact information
Practice address
145 S MARKET BLVD, CHEHALIS, WA 98532-3037
(360) 748-1580
(360) 748-1596
Mailing address
PO BOX 1338, CENTRALIA, WA 98531
(360) 748-1580
(360) 748-1596
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
PT00002809
WA
225100000X
Physical Therapist
Primary
PT00007726
WA
225100000X
Physical Therapist
PT00008819
WA
225100000X
Physical Therapist
PT00009536
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7125966
—
WA
Enumeration date
10/25/2006
Last updated
04/27/2016
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