Healthcare Provider Details

I. General information

NPI: 1689207557
Provider Name (Legal Business Name): THERAPY SERVICES FOR CHILDREN
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/19/2020
Last Update Date: 02/19/2020
Certification Date: 02/19/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11320 ROOSEVELT WAY NE
SEATTLE WA
98125-6228
US

IV. Provider business mailing address

11320 ROOSEVELT WAY NE
SEATTLE WA
98125-6228
US

V. Phone/Fax

Practice location:
  • Phone: 206-362-9169
  • Fax: 206-258-4390
Mailing address:
  • Phone: 206-362-9169
  • Fax: 206-258-4390

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: HEIDI JO HYNES
Title or Position: CEO
Credential:
Phone: 206-362-9169