Provider Demographics
NPI:1225338874
Name:BOTHELL PEDIATRIC AND HAND THERAPY
Entity Type:Organization
Organization Name:BOTHELL PEDIATRIC AND HAND THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:WORKER
Authorized Official - Prefix:
Authorized Official - First Name:JANINE
Authorized Official - Middle Name:
Authorized Official - Last Name:SING
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:425-481-1933
Mailing Address - Street 1:18501 BOTHELL WAY NE
Mailing Address - Street 2:
Mailing Address - City:BOTHELL
Mailing Address - State:WA
Mailing Address - Zip Code:98011
Mailing Address - Country:US
Mailing Address - Phone:425-181-1933
Mailing Address - Fax:425-481-9371
Practice Address - Street 1:18501 BOTHELL WAY NE
Practice Address - Street 2:
Practice Address - City:BOTHELL
Practice Address - State:WA
Practice Address - Zip Code:98011
Practice Address - Country:US
Practice Address - Phone:425-181-1933
Practice Address - Fax:425-481-9371
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-10-29
Last Update Date:2010-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPT601817172251G0304X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2251G0304XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGeriatricsGroup - Single Specialty