Organization
INDEPENDENCE REHAB LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHAD FULLMER (SENIOR VICE PRESIDENT)
(801) 426-4905
Entity
Organization
Contact information
Practice address
919 109TH AVE NE, BELLEVUE, WA 98004-4485
(425) 233-8766
Mailing address
12123 NE 172ND PL, M201, BOTHELL, WA 98011-6409
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
LL60391131
WA
Other
Enumeration date
05/28/2015
Last updated
05/28/2015
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