National Provider Identifier Database

PACIFIC REHABILITATION SPORTS MEDICINE INC
Rehabilitation


Contact Information

PACIFIC REHABILITATION & SPORTS MEDICINE INC
215 S BRIDGE ST
SHERIDAN, OR97378-1807
Phone: 503-843-7617
Fax:
Website:
Specialty Taxonomy Code
* Rehabilitation 261QR0400X

* Indicates primary specialty

NPI Profile & details for PACIFIC REHABILITATION & SPORTS MEDICINE INC

NPI Number 1154383321
Legal business name
LBN
PACIFIC REHABILITATION & SPORTS MEDICINE INC
Authorized official MICHAEL TARVIN - (VICE PRESIDENT)
Entity Organization
Organization subpart No
Enumeration date 04/04/2006
Last updated 09/01/2010 - About 16 years ago
Sole proprietor1 Not specified
Identifiers n/a

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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