Organization
PUSHING BOUNDARIES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. TRICIA LAZZAR (EXECUTIVE DIRECTOR)
(425) 869-9506
Entity
Organization
Contact information
Practice address
4162 148TH AVE NE, REDMOND, WA 98052-5164
(425) 869-9506
Mailing address
4162 148TH AVE NE, REDMOND, WA 98052-5164
(425) 869-9506
Taxonomy
Speciality
Code
Description
License number
State
261QR0400X
Rehabilitation Clinic/Center
Primary
—
—
Other
Enumeration date
01/18/2013
Last updated
01/18/2013
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