Provider Demographics
NPI:1255871299
Name:POWER UP THERAPY, LLC
Entity type:Organization
Organization Name:POWER UP THERAPY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER AND PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:RACHEL
Authorized Official - Middle Name:
Authorized Official - Last Name:DALRYMPLE
Authorized Official - Suffix:
Authorized Official - Credentials:OTR/L
Authorized Official - Phone:425-830-1778
Mailing Address - Street 1:280 NW HOLLY ST
Mailing Address - Street 2:SUITE 10
Mailing Address - City:ISSAQUAH
Mailing Address - State:WA
Mailing Address - Zip Code:98027-2815
Mailing Address - Country:US
Mailing Address - Phone:425-830-1778
Mailing Address - Fax:
Practice Address - Street 1:280 NW HOLLY ST
Practice Address - Street 2:SUITE 10
Practice Address - City:ISSAQUAH
Practice Address - State:WA
Practice Address - Zip Code:98027-2815
Practice Address - Country:US
Practice Address - Phone:425-830-1778
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-02-23
Last Update Date:2017-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0400XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA1073990735OtherNPI INDIVIDUAL