=====================================================
General NPI Number Information
=====================================================
NPI Number | 1740049642
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | SPROUT AND THRIVE LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/14/2024
-----------------------------------------------------
Last Update Date | 07/18/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 23222 E ECHO LAKE RD
-----------------------------------------------------
City | SNOHOMISH
-----------------------------------------------------
State | WA
-----------------------------------------------------
Zip | 98296-6813
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 206-730-3236
-----------------------------------------------------
Fax | 206-735-3778
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 23222 E ECHO LAKE RD
-----------------------------------------------------
City | SNOHOMISH
-----------------------------------------------------
State | WA
-----------------------------------------------------
Zip | 98296-6813
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 206-730-3236
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OCCUPATIONAL THERAPIST, OWNER
-----------------------------------------------------
Name | BREEANA E MILANI
-----------------------------------------------------
Credential | MOT, OTR/L, C/NDT
-----------------------------------------------------
Telephone | 206-730-3236
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 225X00000X
-----------------------------------------------------
Taxonomy Name | Occupational Therapist
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------