Provider Demographics
NPI:1760682116
Name:HIGHLINE HAND THERAPY DBA SOUTHWEST HAND THERAPY
Entity Type:Organization
Organization Name:HIGHLINE HAND THERAPY DBA SOUTHWEST HAND THERAPY
Other - Org Name:SOUTHWEST HAND THERAPY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:LYNNE
Authorized Official - Middle Name:
Authorized Official - Last Name:WOLF
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:206-244-4263
Mailing Address - Street 1:275 SW 160TH ST
Mailing Address - Street 2:STE. 201
Mailing Address - City:BURIEN
Mailing Address - State:WA
Mailing Address - Zip Code:98166-3003
Mailing Address - Country:US
Mailing Address - Phone:206-244-4263
Mailing Address - Fax:206-244-8703
Practice Address - Street 1:4621 35TH AVE SW
Practice Address - Street 2:STE. A
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98126-2767
Practice Address - Country:US
Practice Address - Phone:206-935-1215
Practice Address - Fax:206-935-0207
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HIGHLINE HAND THERAPY INC. PS
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-07-24
Last Update Date:2007-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA332BC3200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA7136948Medicaid
WAHI0027OtherREGENCE
WA7683881Medicaid