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10119 Highway 12 Sw, Rochester, WA 98579-8621 | |
(360) 273-4747 | |
(360) 273-4747 |
Full Name | |
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Type | Facility |
Speciality | Physical Therapist |
Location | 10119 Highway 12 Sw, Rochester, Washington |
Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1508196502 | NPI | - | NPPES |
7145766 | Medicaid | WA | |
2496SC | Other | WA | REGENCE BLUE SHIELD |
236625 | Other | WA | DEPARTMENT OF LABOR & INDUSTRIES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
225100000X | Physical Therapist | PT00003851 (Washington) | Primary |
Provider Name | Lisa A Scheuffele |
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Provider Type | Practitioner - Physical Therapist In Private Practice |
Provider Identifiers | NPI Number: 1730367368 PECOS PAC ID: 8820060916 Enrollment ID: I20040810000147 |
Mailing Address | Practice Location Address |
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Po Box 306, Fox Island, WA 98333-0306 Ph: (360) 273-4747 | 10119 Highway 12 Sw, Rochester, WA 98579-8621 Ph: (360) 273-4747 |