Organization
INTEGRATED REHABILITATION GROUP, PC
Active
Parent organization
INTEGRATED REHABILITATION GROUP, PC
Other names
Granite Falls Physical Therapy, IRG Physical & Hand Therapy - Granite Falls
Organization subpart
Yes
Provider details
NPI number
Legal business name
INTEGRATED REHABILITATION GROUP, PC
Authorized official
MICHAEL SHANNON O'KELLEY MPT (PRESIDENT/OWNER)
(425) 316-8046
Entity
Organization
Contact information
Practice address
403 W STANLEY ST, GRANITE FALLS, WA 98252-8631
(360) 691-4835
(360) 691-2545
Mailing address
4220 132ND ST SE, SUITE 101, MILL CREEK, WA 98012-8999
(425) 316-8046
(425) 338-9637
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
—
—
261QP2000X
Physical Therapy Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0159241
DEPT. OF LABOR & INDUSTRY
WA
01
—
3791726-04
OWCP
WA
01
—
462797002
GROUP HEALTH MEDICARE
WA
01
—
462797005
GROUP HEALTH NON-MEDICARE
WA
05
—
7083322
—
WA
01
—
8928201
L&I CRIME VICTIMS
WA
05
—
9055039
—
WA
Enumeration date
06/10/2006
Last updated
12/28/2023
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