Provider Demographics
NPI:1912117342
Name:UNITED CEREBRAL PALSY OF SOUTH PUGET SOUND
Entity Type:Organization
Organization Name:UNITED CEREBRAL PALSY OF SOUTH PUGET SOUND
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:MARGE
Authorized Official - Middle Name:T
Authorized Official - Last Name:SCHWICKERATH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:253-565-1463
Mailing Address - Street 1:3720 6TH AVE
Mailing Address - Street 2:SUITE C
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98406-4938
Mailing Address - Country:US
Mailing Address - Phone:253-565-1463
Mailing Address - Fax:253-565-0153
Practice Address - Street 1:3720 6TH AVE
Practice Address - Street 2:SUITE C
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98406-4938
Practice Address - Country:US
Practice Address - Phone:253-565-1463
Practice Address - Fax:253-565-0153
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-23
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225A00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMusic TherapistGroup - Single Specialty