Provider Demographics
NPI:1477292894
Name:MILESTONE THERAPY PLLC
Entity Type:Organization
Organization Name:MILESTONE THERAPY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER, OCCUPATIONAL THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:MINDI
Authorized Official - Middle Name:
Authorized Official - Last Name:KNUDSON
Authorized Official - Suffix:
Authorized Official - Credentials:OT
Authorized Official - Phone:316-841-8528
Mailing Address - Street 1:4162 GROTTO CT SW
Mailing Address - Street 2:
Mailing Address - City:OLYMPIA
Mailing Address - State:WA
Mailing Address - Zip Code:98512-7824
Mailing Address - Country:US
Mailing Address - Phone:316-841-8528
Mailing Address - Fax:
Practice Address - Street 1:1880 BARNES BLVD SW
Practice Address - Street 2:
Practice Address - City:TUMWATER
Practice Address - State:WA
Practice Address - Zip Code:98512-1435
Practice Address - Country:US
Practice Address - Phone:316-841-8528
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-06-02
Last Update Date:2022-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Single Specialty