Healthcare Provider Details

I. General information

NPI: 1922193648
Provider Name (Legal Business Name): ANACORTES CHILDRENS THERAPY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/04/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1101 8TH ST STE B
ANACORTES WA
98221-1800
US

IV. Provider business mailing address

PO BOX 11009
OLYMPIA WA
98508-1009
US

V. Phone/Fax

Practice location:
  • Phone: 360-299-0331
  • Fax: 360-299-0336
Mailing address:
  • Phone: 360-352-2037
  • Fax: 360-352-0637

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License Number
License Number State

VIII. Authorized Official

Name: LAUREEN FRANKLIN
Title or Position: OWNER
Credential: MS, OTR/L
Phone: 360-299-0331