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General NPI Number Information
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NPI Number | 1922710664
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Entity Type | Organization
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Legal Business Name | RAINBOW PEDIATRIC OCCUPATIONAL THERAPY PLLC
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Dates
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Enumeration Date | 12/14/2022
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Last Update Date | 12/14/2022
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Provider Practice Location Address
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Address Line | 6722 34TH AVE SW
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City | SEATTLE
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State | WA
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Zip | 98126-4208
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Country | US
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Telephone | 425-686-9177
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Fax |
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Provider Business Mailing Address
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Address Line | 6523 CALIFORNIA AVE SW # 350
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City | SEATTLE
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State | WA
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Zip | 98136-1833
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Country | US
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Telephone | 425-686-9177
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Fax |
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Authorized Official
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Title or Position | PROVIDER/SOLE OWNER
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Name | CAITLIN SIMONEAUX
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Credential | OT
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Telephone | 425-686-9177
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225XP0200X
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Taxonomy Name | Pediatric Occupational Therapist
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License Number |
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License Number State |
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