REVERVE LLC (NPI# 1023671625) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1023671625 |
| Entity Type | Organization |
| Organization Name | REVERVE LLC |
| Practice Address |
114 Alaskan Way S Apt 506 Seattle WA 98104-2585 |
| Mailing Address |
114 Alaska Way S Suite 506 Seattle WA 98104 |
| Practice Telephone | 2064873391 |
| Practice Fax Number | 8662643391 |
| Mailing Telephone | 2064873391 |
| Mailing Fax Number | 8662643391 |
| Enumeration Date | 2019-04-18 |
| Last Update Date | 2019-06-24 |
| Authorized Official Name | JANELLE GUERRERO (BILLING) |
| Authorized Official Telephone | 8776696927 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2251S0007X |
Physical Therapist Specialization: Sports |
Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WA | WASHINGTON STATE DOL PHYSICAL THERAPY | PT60468708 | 01 |
| Street Address |
114 ALASKAN WAY S APT 506 |
| City | SEATTLE |
| State | WA |
| Zip Code | 98104-2585 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861893711 | Chason Lee Hendryx | Physical Therapist | 114 Alaskan Way S Apt 506, Seattle, WA 98104-2585 | 2014-09-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699394312 | Richard Charles Harruff | Pathology | King County Medical Examiners Office, 325 Ninth Avenue, Seattle, WA 98104 | 2020-04-13 |
| 1558999474 | Nathan Richard Benner | Student in an Organized Health Care Education/Training Program | Uw Medicine-harborview Medical Center Orthopaedics, 325 Ninth Avenue, Seattle, WA 98104 | 2020-03-27 |
| 1063058493 | Brook, LLC. | Health Educator | 311 1/2 Occidental Ave South, Suite 210, Seattle, WA 98104 | 2019-11-20 |
| 1609418813 | Stephanie Amanda Ann Mason | Student in an Organized Health Care Education/Training Program | 325 9th Avenue, Mail Stop #359796, Seattle, WA 98104 | 2019-10-09 |
| 1013480250 | Robert Kenneth Lozier | Pedorthist | Norm Maleng Building, 410 9th Ave, 4th Floor, Seattle, WA 98104 | 2019-01-10 |
| 1548739576 | Lee Hanses | Physical Therapist | 1124 Columbia Street, Level P1, Suite P100, Seattle, WA 98104 | 2018-11-20 |
| 1821579095 | Karissa Lin Lee | Pharmacist | 401 Broadway #2075, Seattle, WA 98104 | 2018-08-27 |
| 1477042091 | Maham Jehangir | Student in an Organized Health Care Education/Training Program | 325 9th Ave Department of Radiology, Seattle, WA 98104 | 2018-05-09 |
| 1740786581 | Philip Daniel Tolley | Student in an Organized Health Care Education/Training Program | 325 9th Ave. Mail Stop#359796, 7th Floor Center Tower Rm #73.1, Seattle, WA 98104 | 2018-04-02 |
| 1528564242 | Vanessa Dawn Leonhard | Student in an Organized Health Care Education/Training Program | 325 9th Ave, 7th Floor Center Tower Room 73.1, Mail Stop #359796, Seattle, WA 98104 | 2018-04-02 |
| Find all providers in zip 98104 | ||||
| Taxonomy Code | 2251S0007X |
| Grouping | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Classification | Physical Therapist |
| Specialization | Sports |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407993553 | Randy A Notebloom | Physical Therapist | 904 7th Ave, Seattle, WA 98104-1132 | 2007-01-30 |
| 1356413280 | Jet City Enterprists Inc | Physical Therapist | 11304 8th Ave Ne, Suite A, Seattle, WA 98125-6111 | 2006-11-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083941264 | Steven Wesley Heinrich | Physical Therapist | 1322 North Ash Street, Walgreens / Option Care Home Care, Spokane, WA 99201-2804 | 2009-11-10 |
| 1386252484 | Corey M O'malley Pt, Dpt, Pllc | Physical Therapist | 12707 120th Ave Ne Ste 100, Kirkland, WA 98034-7500 | 2020-07-15 |
| 1891276994 | Caitlin Paskewich | Physical Therapist | 110 110th Ave Ne Ste 110, Bellevue, WA 98004-5840 | 2018-08-27 |
| 1003218447 | Robert Joseph Roller Jr. | Physical Therapist | 9040 Jackson Ave, Tacoma, WA 98431-0001 | 2014-09-17 |
| 1740689520 | G4 Athlete LLC | Physical Therapist | 2737 77th Ave Se, Suite 214, Mercer Island, WA 98040-2830 | 2014-08-18 |
| 1629414123 | Michael James Tankovich | Physical Therapist | 12 Seahawks Way, Renton, WA 98056-1572 | 2013-05-11 |
| 1629192497 | Rebecca A Forkan | Physical Therapist | 20109 Aurora Ave N Ste 105, Shoreline, WA 98133-3127 | 2007-03-19 |
| 1922087386 | Erin E Patterson | Physical Therapist | Naval Hospital Bremerton, Bremerton, WA 98370-0000 | 2006-01-13 |
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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.