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NPI Code Detail

MEDICARE: CIRCLE CREEK THERAPY PLLC

MEDICARE: CIRCLE CREEK THERAPY PLLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1261QH0700XHearing and Speech Clinic/Center603544948WA
21041C0700XClinical Social Worker
3225100000XPhysical Therapist
4225X00000XOccupational Therapist
5235Z00000XSpeech-Language Pathologist
6261QM1300XMulti-Specialty Clinic/Center

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1326418310
Entity Type Code : Organization
Provider Name (Legal Business Name) : CIRCLE CREEK THERAPY PLLC
Provider Business Mailing Address
First Line : 1314 AUBURN WAY N
Second Line :
City : AUBURN
State : WA
Zip : 98002-4109
Country : US
Telephone Number : 253-237-3405
Fax Number : 253-426-3096
Provider Business Practice Location Address
First Line : 1314 AUBURN WAY N
Second Line :
City : AUBURN
State : WA
Zip : 98002-4109
Country : US
Telephone Number : 253-237-3405
Fax Number : 253-426-3096
Authorized Official
Title or Position : OWNER
Name : MRS. COURTNI D DOHERTY
Credential : MS, CCC-SLP
Telephone Number : 253-237-3405
Provider Enumeration Date : 10/02/2015
Last Update Date : 01/28/2025

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Directions to “CIRCLE CREEK THERAPY PLLC ” Practice Location

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