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Organization

AVAMERE OUTPATIENT SERVICES, LLC

Active
Other names
Northshore Physical Therapy
Organization subpart
No

Provider details

NPI number
Authorized official
RICK MCDANIEL (PRESIDENT)
(888) 757-3422
Entity
Organization

Contact information

Practice address
18107 BOTHELL WAY NE, SUITE 106, BOTHELL, WA 98011-1900
(425) 487-3142
Mailing address
25117 SW PARKWAY AVE, SUITE D, WILSONVILLE, OR 97070-9697
(971) 224-2037

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
G8873164
PTAN
WA
Enumeration date
04/15/2008
Last updated
05/22/2012
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