Provider Demographics
NPI:1740415207
Name:LITTLE BIT THERAPEUTIC RIDING CENTER
Entity type:Organization
Organization Name:LITTLE BIT THERAPEUTIC RIDING CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:KATHY
Authorized Official - Middle Name:
Authorized Official - Last Name:ALM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:425-882-1554
Mailing Address - Street 1:19802 NE 148TH ST
Mailing Address - Street 2:
Mailing Address - City:WOODINVILLE
Mailing Address - State:WA
Mailing Address - Zip Code:98077-7698
Mailing Address - Country:US
Mailing Address - Phone:425-882-1554
Mailing Address - Fax:
Practice Address - Street 1:19802 NE 148TH ST
Practice Address - Street 2:
Practice Address - City:WOODINVILLE
Practice Address - State:WA
Practice Address - Zip Code:98077-7698
Practice Address - Country:US
Practice Address - Phone:425-882-1554
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-05-27
Last Update Date:2009-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA9994225100000X
WA10126225100000X
WA60082412225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty