Provider Demographics
NPI:1184996803
Name:WAYPOINT PEDIATRIC THERAPIES
Entity type:Organization
Organization Name:WAYPOINT PEDIATRIC THERAPIES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER, PEDIATRIC PHYSICAL THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:ALLISON
Authorized Official - Middle Name:A
Authorized Official - Last Name:YOCUM
Authorized Official - Suffix:
Authorized Official - Credentials:PT, DSC, PCS
Authorized Official - Phone:425-830-0028
Mailing Address - Street 1:22526 SE 64TH PL
Mailing Address - Street 2:SUITE 140
Mailing Address - City:ISSAQUAH
Mailing Address - State:WA
Mailing Address - Zip Code:98027-5368
Mailing Address - Country:US
Mailing Address - Phone:425-830-0028
Mailing Address - Fax:
Practice Address - Street 1:22526 SE 64TH PL
Practice Address - Street 2:SUITE 140
Practice Address - City:ISSAQUAH
Practice Address - State:WA
Practice Address - Zip Code:98027-5368
Practice Address - Country:US
Practice Address - Phone:425-830-0028
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-01-27
Last Update Date:2016-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA00008228225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty