Provider Demographics
NPI:1619907300
Name:HARBOR CHILDREN'S THERAPY, L.L.C.
Entity Type:Organization
Organization Name:HARBOR CHILDREN'S THERAPY, L.L.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CLINICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:LOIS
Authorized Official - Middle Name:E
Authorized Official - Last Name:KRAMER
Authorized Official - Suffix:
Authorized Official - Credentials:MS,OTR/L
Authorized Official - Phone:253-853-5155
Mailing Address - Street 1:5334 OLYMPIC DR NW
Mailing Address - Street 2:SUITE 101
Mailing Address - City:GIG HARBOR
Mailing Address - State:WA
Mailing Address - Zip Code:98335-1722
Mailing Address - Country:US
Mailing Address - Phone:253-853-5155
Mailing Address - Fax:253-853-5150
Practice Address - Street 1:5334 OLYMPIC DR NW
Practice Address - Street 2:SUITE 101
Practice Address - City:GIG HARBOR
Practice Address - State:WA
Practice Address - Zip Code:98335-1722
Practice Address - Country:US
Practice Address - Phone:253-853-5155
Practice Address - Fax:253-853-5150
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-05
Last Update Date:2011-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA7681729Medicaid