Basic Information
| Provider Information | |||||||||
| NPI: | 1316903123 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | RPM REHAB, INC | ||||||||
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| OtherOrganizationName: | CASCADE SUMMIT PHYSICAL THERAPY | ||||||||
| OtherOrganizationType: | 3 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 330 FRANKLIN RD | ||||||||
| Address2: | STE 135A-102 | ||||||||
| City: | BRENTWOOD | ||||||||
| State: | TN | ||||||||
| PostalCode: | 370273280 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7602562800 | ||||||||
| FaxNumber: | 7602562809 | ||||||||
| Practice Location | |||||||||
| Address1: | 1608 SOUTH 24TH AVE | ||||||||
| Address2: | STE 102 | ||||||||
| City: | YAKIMA | ||||||||
| State: | WA | ||||||||
| PostalCode: | 989025719 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5092486113 | ||||||||
| FaxNumber: | 5094578941 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/21/2006 | ||||||||
| LastUpdateDate: | 12/30/2014 | ||||||||
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| AuthorizedOfficialLastName: | HAWES | ||||||||
| AuthorizedOfficialFirstName: | JOHN | ||||||||
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| AuthorizedOfficialTitleorPosition: | CEO/PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 6157502067 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225100000X | PT00003868 | WA | N | 193200000X MULTI-SPECIALTY GROUP | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist | 225700000X | Y | 193200000X MULTI-SPECIALTY GROUP | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Massage Therapist |
ID Information
| ID | Type | State | Issuer | Description | 7087117 | 05 | WA | MEDICAID |