Basic Information
| Provider Information | |||||||||
| NPI: | 1013133966 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | CASCADE SUMMIT PHYSICAL THERAPY INC PS | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3901 CREEKSIDE LOOP | ||||||||
| Address2: | SUITE 102 | ||||||||
| City: | YAKIMA | ||||||||
| State: | WA | ||||||||
| PostalCode: | 98902 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5092486113 | ||||||||
| FaxNumber: | 5094578941 | ||||||||
| Practice Location | |||||||||
| Address1: | 3901 CREEKSIDE LOOP | ||||||||
| Address2: | SUITE 102 | ||||||||
| City: | YAKIMA | ||||||||
| State: | WA | ||||||||
| PostalCode: | 98902 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5092486113 | ||||||||
| FaxNumber: | 5094578941 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/18/2007 | ||||||||
| LastUpdateDate: | 08/22/2020 | ||||||||
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| AuthorizedOfficialLastName: | BRADEN | ||||||||
| AuthorizedOfficialFirstName: | KAREN | ||||||||
| AuthorizedOfficialMiddleName: | E | ||||||||
| AuthorizedOfficialTitleorPosition: | VP | ||||||||
| AuthorizedOfficialTelephone: | 5092498704 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | PT | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225100000X | Y | 193400000X SINGLE SPECIALTY GROUP | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist |
No ID Information.