Provider Demographics
NPI:1881717312
Name:CHILDREN'S INSTITUTE FOR LEARNING DIFFERENCES
Entity type:Organization
Organization Name:CHILDREN'S INSTITUTE FOR LEARNING DIFFERENCES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR, CLINICAL SERVICES
Authorized Official - Prefix:
Authorized Official - First Name:CATHERINE
Authorized Official - Middle Name:
Authorized Official - Last Name:DELEON
Authorized Official - Suffix:
Authorized Official - Credentials:OTR
Authorized Official - Phone:206-232-3588
Mailing Address - Street 1:4030 86TH AVE SE
Mailing Address - Street 2:SUITE F
Mailing Address - City:MERCER ISLAND
Mailing Address - State:WA
Mailing Address - Zip Code:98040-4198
Mailing Address - Country:US
Mailing Address - Phone:206-232-8680
Mailing Address - Fax:206-232-9377
Practice Address - Street 1:4030 86TH AVE SE
Practice Address - Street 2:SUITE F
Practice Address - City:MERCER ISLAND
Practice Address - State:WA
Practice Address - Zip Code:98040-4198
Practice Address - Country:US
Practice Address - Phone:206-232-8680
Practice Address - Fax:206-232-9377
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-09
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAOT00001551225X00000X
WALL00003582235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty
Not Answered235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty