Provider Demographics
NPI:1205875150
Name:HIGHLINE HAND THERAPY DBA SOUTHWEST HAND THERAPY SERVICES
Entity type:Organization
Organization Name:HIGHLINE HAND THERAPY DBA SOUTHWEST HAND THERAPY SERVICES
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:VICE PRESISENTCLINICAL SUPERVISOR
Authorized Official - Prefix:MS
Authorized Official - First Name:LYNNE
Authorized Official - Middle Name:
Authorized Official - Last Name:WOLF
Authorized Official - Suffix:
Authorized Official - Credentials:OTR,L,CHT
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:98126-2707
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 P S
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-06-06
Last Update Date:2007-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA225XH1200X, 225100000X, 225X00000X, 2251H1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2251H1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistHandGroup - Multi-Specialty
No225XH1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistHandGroup - Multi-Specialty
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA7055858Medicaid
WA7680655Medicaid
WA31570OtherDEPT. OF LABOR&INDUSTRIES
WAHI0027OtherREGENCE
WA8909011OtherCRIME VICTUMS