Healthcare Provider Details

I. General information

NPI: 1346165511
Provider Name (Legal Business Name): TRILLIUM PEDIATRIC THERAPY PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/13/2026
Last Update Date: 08/13/2026
Certification Date: 08/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

509 WASHINGTON AVE
SANDPOINT ID
83864-2012
US

IV. Provider business mailing address

509 WASHINGTON AVE
SANDPOINT ID
83864-2012
US

V. Phone/Fax

Practice location:
  • Phone: 208-261-2166
  • Fax:
Mailing address:
  • Phone: 208-261-2166
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License Number
License Number State

VIII. Authorized Official

Name: RACHEL MILANEZ
Title or Position: OWNER
Credential: MOTR/L
Phone: 503-516-3736