PEDIATRIC REHABILITATION ASSOCIATES PLLC (NPI# 1770020992) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1770020992 |
| Entity Type | Organization |
| Organization Name | PEDIATRIC REHABILITATION ASSOCIATES PLLC |
| Practice Address |
1907 Cooks Hill Rd Centralia WA 98531-9073 |
| Mailing Address |
117 E Louisa St #370 Seattle WA 98102-3203 |
| Practice Telephone | 2532680720 |
| Mailing Telephone | 2063291468 |
| Enumeration Date | 2017-01-25 |
| Last Update Date | 2017-01-25 |
| Authorized Official Name | SUSAN QUIGLEY (MD/OWNER) |
| Authorized Official Telephone | 2064820103 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 2081P0301X |
Physical Medicine & Rehabilitation Specialization: Brain Injury Medicine |
MD60570885 | WA | Allopathic & Osteopathic Physicians |
| Y | 2081P0010X |
Physical Medicine & Rehabilitation Specialization: Pediatric Rehabilitation Medicine |
MD60570885 | WA | Allopathic & Osteopathic Physicians |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Washington State Corporations | PEDIATRIC REHABILITATION ASSOCIATES PLLC | 117 E Louisa St Ste 370, Seattle, WA 98102-3203 |
| Street Address |
1907 COOKS HILL RD |
| City | CENTRALIA |
| State | WA |
| Zip Code | 98531-9073 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093213241 | Summit Speech and Language, LLC | Speech-Language Pathologist | 1907 Cooks Hill Rd, Centralia, WA 98531-9073 | 2018-01-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306462205 | Jelisa Renae Thomas | Counselor | 3510 Steelhammer Ln, Centralia, WA 98531 | 2020-06-17 |
| 1205498607 | Jennifer Kristine Mcglynn Paterno | Counselor | 2428 W. Reynods Ave, Centralia, WA 98531 | 2019-07-05 |
| 1538646328 | Adam Jeffrey Moore | Counselor | 3510 Steelhammer Lane, Centralia, WA 98531 | 2018-07-24 |
| 1144706698 | Euijeong Kim | Occupational Therapist | Rehabilitation Therapies, 914 S. Scheuber Rd, Centralia, WA 98531 | 2018-07-18 |
| 1104315266 | Margaret Fowler Floyd | Registered Nurse | Centralia High School, 813 Eshom Road, Centralia, WA 98531 | 2018-05-04 |
| 1124545777 | Samantha Michelle Moody | Speech-Language Pathologist | Centralia School District, 2320 Borst Ave, Centralia, WA 98531 | 2017-08-24 |
| 1821520289 | Alexa Franks | Behavior Technician | 2428 West Reynolds Ave., Centralia, WA 98531 | 2017-04-03 |
| 1023559861 | Brandy Michelle Peterson | Counselor | 135 W. Main Steet, Centralia, WA 98531 | 2017-03-13 |
| 1841738812 | Graceful Healing Naturopathic | Naturopath | 219 N Tower Ave, Suite 304, Centralia, WA 98531 | 2017-02-09 |
| 1043681513 | Angela Naillon | Counselor | 2428 West Reynolds, Centralia, WA 98531 | 2015-10-09 |
| Find all providers in zip 98531 | ||||
| Taxonomy Code | 2081P0010X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Physical Medicine & Rehabilitation |
| Specialization | Pediatric Rehabilitation Medicine |
| A physiatrist who utilizes an interdisciplinary approach and addresses the prevention, diagnosis, treatment and management of congenital and childhood-onset physical impairments including related or secondary medical, physical, functional, psychosocial and vocational limitations or conditions, with an understanding of the life course of disability. This physician is trained in the identification of functional capabilities and selection of the best of rehabilitation intervention strategies, with an understanding of the continuum of care. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition changed, source added] Additional Resources: American Board of Physical Medicine and Rehabilitation, 2007. http://www.abpmr.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Physical Medicine and Rehabilitation. A subspecialty certificate for PRM was approved by the ABMS in 1999. ACGME Accredited Residency Program Requirements: Early discussions underway |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003463233 | Scott Patrick Shelton | Physical Medicine & Rehabilitation | 111 Bethel St Ne, Olympia, WA 98506-4365 | 2019-08-22 |
| 1508410663 | Shelly Marie Kvamme | Physical Medicine & Rehabilitation | 15510 1st Ave Ne, Duvall, WA 98019-6000 | 2019-07-27 |
| 1326177700 | Jessica Ann Matous | Physical Medicine & Rehabilitation | 1010 Washington St Ste 280, Vancouver, WA 98660-3168 | 2007-03-03 |
| 1912092628 | Elizabeth Beck Wilson-fowler | Physical Medicine & Rehabilitation | 1101 8th St Ste B, Anacortes, WA 98221-1800 | 2006-10-04 |
| 1750785317 | Daniel William Kalani Kruse | Physical Medicine & Rehabilitation | 6912 220th St Sw, 200, Mountlake Terrace, WA 98043-2169 | 2014-10-10 |
| 1700205945 | Megan Flanigan | Physical Medicine & Rehabilitation | 311 S L St, Tacoma, WA 98405-4289 | 2014-04-15 |
| 1609213560 | Jaclyn Christine Omura | Physical Medicine & Rehabilitation | 4800 Sand Point Way Ne, Seattle, WA 98105 | 2013-05-31 |
| 1083994958 | Non Surgical Spine & Joint Clinic Ps | Physical Medicine & Rehabilitation | 12 Bellwether Way, Suite 219, Bellingham, WA 98225-2959 | 2011-08-24 |
| 1184870396 | Elaine Y Tsao | Physical Medicine & Rehabilitation | 4800 Sand Point Way Ne, Department of Rehabilitation Medicine, Seattle, WA 98105 | 2008-08-07 |
| 1295905909 | Desiree Roge | Physical Medicine & Rehabilitation | 4800 Sand Point Way Ne, Seattle, WA 98105 | 2008-03-10 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.