Provider Demographics
NPI:1689100133
Name:NANCE REHABILITATION SERVICES PLLC
Entity type:Organization
Organization Name:NANCE REHABILITATION SERVICES PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER/ DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:DALE
Authorized Official - Last Name:NANCE
Authorized Official - Suffix:JR
Authorized Official - Credentials:MPT
Authorized Official - Phone:425-246-9799
Mailing Address - Street 1:22840 NE 8TH ST STE 102
Mailing Address - Street 2:
Mailing Address - City:SAMMAMISH
Mailing Address - State:WA
Mailing Address - Zip Code:98074-7263
Mailing Address - Country:US
Mailing Address - Phone:425-898-8540
Mailing Address - Fax:
Practice Address - Street 1:22840 NE 8TH ST STE 102
Practice Address - Street 2:
Practice Address - City:SAMMAMISH
Practice Address - State:WA
Practice Address - Zip Code:98074-7263
Practice Address - Country:US
Practice Address - Phone:425-898-8540
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-05-03
Last Update Date:2017-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA000085532251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedicGroup - Single Specialty