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Organization

PEDIATRIC REHABILITATION NORTHWEST

Active
Other names
PRNW
Organization subpart
No

Provider details

NPI number
Authorized official
KYLE DAVEY (CEO)
(209) 769-2039
Entity
Organization

Contact information

Practice address
655 MULE DEER ST NW, SALEM, OR 97304-3678
(209) 769-2039
Mailing address
655 MULE DEER ST NW, SALEM, OR 97304-3678
(209) 769-2039

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
235Z00000X
Speech-Language Pathologist
Primary

Other

Enumeration date
12/01/2022
Last updated
12/01/2022
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