Healthcare Provider Details

I. General information

NPI: 1720806797
Provider Name (Legal Business Name): THERAPEUTIC RIDING OF TRI-CITIES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/30/2024
Last Update Date: 09/30/2024
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

104 E. 41ST PLACE
KENNEWICK WA
99337
US

IV. Provider business mailing address

P.O. BOX 5108
PASCO WA
99302
US

V. Phone/Fax

Practice location:
  • Phone: 509-412-0112
  • Fax:
Mailing address:
  • Phone: 509-412-0112
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2251P0200X
TaxonomyPediatric Physical Therapist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State
# 5
Primary TaxonomyY
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: CYNTHIA MACFARLAN
Title or Position: FOUNDER/ EXECUTIVE DIRECTOR
Credential: MS, CCC/SLP
Phone: 509-430-2215