Healthcare Provider Details

I. General information

NPI: 1912117342
Provider Name (Legal Business Name): UNITED CEREBRAL PALSY OF SOUTH PUGET SOUND
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/23/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3720 6TH AVE SUITE C
TACOMA WA
98406-4938
US

IV. Provider business mailing address

3720 6TH AVE SUITE C
TACOMA WA
98406-4938
US

V. Phone/Fax

Practice location:
  • Phone: 253-565-1463
  • Fax: 253-565-0153
Mailing address:
  • Phone: 253-565-1463
  • Fax: 253-565-0153

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225A00000X
TaxonomyMusic Therapist
License Number
License Number State

VIII. Authorized Official

Name: MS. MARGE T SCHWICKERATH
Title or Position: PRESIDENT CEO
Credential:
Phone: 253-565-1463