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General NPI Number Information
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NPI Number | 1619646684
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Entity Type | Organization
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Legal Business Name | LITTLE BY LITTLE LIFESTYLE
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Dates
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Enumeration Date | 09/12/2021
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Last Update Date | 09/12/2021
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Provider Practice Location Address
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Address Line | 16300 AURORA AVE N STE C
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City | SHORELINE
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State | WA
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Zip | 98133-2602
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Country | US
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Telephone | 206-713-3127
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Fax |
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Provider Business Mailing Address
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Address Line | 19133 12TH AVE NW
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City | SHORELINE
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State | WA
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Zip | 98177-2645
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | JENNIFER WONG
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Credential |
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Telephone | 206-713-3127
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0400X
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Taxonomy Name | Rehabilitation Clinic/Center
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License Number |
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License Number State |
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