Provider Demographics
NPI:1720449143
Name:BLUE MOUNTAIN THERAPEUTIC RIDING
Entity Type:Organization
Organization Name:BLUE MOUNTAIN THERAPEUTIC RIDING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:MARY
Authorized Official - Middle Name:BELLE
Authorized Official - Last Name:MURPHY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:509-540-6244
Mailing Address - Street 1:1280 LOWDEN GARDENA RD
Mailing Address - Street 2:
Mailing Address - City:TOUCHET
Mailing Address - State:WA
Mailing Address - Zip Code:99360-9632
Mailing Address - Country:US
Mailing Address - Phone:509-540-6244
Mailing Address - Fax:
Practice Address - Street 1:1280 LOWDEN GARDENA RD
Practice Address - Street 2:
Practice Address - City:TOUCHET
Practice Address - State:WA
Practice Address - Zip Code:99360-9632
Practice Address - Country:US
Practice Address - Phone:509-540-6244
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-03-12
Last Update Date:2016-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA603283335385H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes385H00000XRespite Care FacilityRespite Care