Healthcare Provider Details

I. General information

NPI: 1881946432
Provider Name (Legal Business Name): LINDA HIGGINS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/05/2012
Last Update Date: 10/05/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

315 129TH ST S
TACOMA WA
98444-5044
US

IV. Provider business mailing address

315 129TH ST S
TACOMA WA
98444-5044
US

V. Phone/Fax

Practice location:
  • Phone: 253-298-3000
  • Fax:
Mailing address:
  • Phone: 253-298-3000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License NumberOT00000214
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: