Organization
ESRC PLLC
Active
Other names
Eastside Sports Rehabilitation Clinics, Eastside Sports Rehab
Organization subpart
No
Provider details
NPI number
Authorized official
MS. NICOLE PARK (BILLING MANAGER)
(425) 576-8180
Entity
Organization
Contact information
Practice address
11400 SE 6TH ST STE 105, BELLEVUE, WA 98004-6419
(425) 576-8180
(425) 746-2002
Mailing address
11400 SE 6TH ST STE 105, BELLEVUE, WA 98004-6419
(425) 576-8180
(425) 576-2002
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
—
—
261QP2000X
Physical Therapy Clinic/Center
Primary
—
—
Other
Enumeration date
07/22/2006
Last updated
06/18/2020
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