Provider Demographics
NPI:1295404002
Name:CEDAR CHILDRENS THERAPY LLC
Entity Type:Organization
Organization Name:CEDAR CHILDRENS THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OCCUPATIONAL THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:CLAIRE
Authorized Official - Middle Name:ELIZABETH
Authorized Official - Last Name:BAZLEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:425-681-2131
Mailing Address - Street 1:333 S STATE ST STE V341
Mailing Address - Street 2:
Mailing Address - City:LAKE OSWEGO
Mailing Address - State:OR
Mailing Address - Zip Code:97034-3932
Mailing Address - Country:US
Mailing Address - Phone:425-681-2131
Mailing Address - Fax:
Practice Address - Street 1:333 S STATE ST STE V341
Practice Address - Street 2:
Practice Address - City:LAKE OSWEGO
Practice Address - State:OR
Practice Address - Zip Code:97034-3932
Practice Address - Country:US
Practice Address - Phone:425-681-2131
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-09-07
Last Update Date:2021-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Single Specialty