Organization
PREMERE REHAB LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LAURA CANTRELL P.T. (DIRECTOR OF OUTPATIENT)
(360) 901-8111
Entity
Organization
Contact information
Practice address
13505 SE RIVER RD, PORTLAND, OR 97222-8038
(503) 652-4011
Mailing address
25117 SW PARKWAY AVE STE D, WILSONVILLE, OR 97070-9697
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
225X00000X
Occupational Therapist
—
—
235Z00000X
Speech-Language Pathologist
—
—
Other
Enumeration date
08/13/2008
Last updated
01/02/2013
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