Organization
AVAMERE OUTPATIENT SERVICES, LLC
Active
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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