Healthcare Provider Details
I. General information
NPI: 1831152636
Provider Name (Legal Business Name): HIGHLINE HAND THERAPY INC P S
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 04/11/2006
Last Update Date: 06/20/2008
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
275 SW 160TH ST STE. 201
BURIEN WA
98166-3003
US
IV. Provider business mailing address
275 SW 160TH ST STE. 201
BURIEN WA
98166-3003
US
V. Phone/Fax
- Phone: 206-244-4263
- Fax: 206-244-8703
- Phone: 206-244-4263
- Fax: 206-244-8703
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 225100000X |
| Taxonomy | Physical Therapist |
| License Number | |
| License Number State | WA |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 225XH1200X |
| Taxonomy | Hand Occupational Therapist |
| License Number | |
| License Number State | WA |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2251H1200X |
| Taxonomy | Hand Physical Therapist |
| License Number | |
| License Number State | WA |
| # 4 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 225X00000X |
| Taxonomy | Occupational Therapist |
| License Number | |
| License Number State | WA |
VIII. Authorized Official
Name: MS.
LYNNE
WOLF
Title or Position: VICE PRESIDENT CLINICAL SUPERVISOR
Credential: OTR L CHT CVE
Phone: 206-244-4263