Provider Demographics
NPI:1922812585
Name:RAISE THE BAR PHYSICAL THERAPY AND WELLNESS
Entity type:Organization
Organization Name:RAISE THE BAR PHYSICAL THERAPY AND WELLNESS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICAL THERAPIST/ OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DESIRAE
Authorized Official - Middle Name:
Authorized Official - Last Name:LYALL
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:509-492-2545
Mailing Address - Street 1:6509 ROAD 84 PL
Mailing Address - Street 2:
Mailing Address - City:PASCO
Mailing Address - State:WA
Mailing Address - Zip Code:99301-7706
Mailing Address - Country:US
Mailing Address - Phone:509-492-2545
Mailing Address - Fax:
Practice Address - Street 1:5820 ROAD 92 STE 206
Practice Address - Street 2:
Practice Address - City:PASCO
Practice Address - State:WA
Practice Address - Zip Code:99301-2678
Practice Address - Country:US
Practice Address - Phone:509-492-2545
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-02-04
Last Update Date:2025-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty