Provider Demographics
NPI:1134743461
Name:HEALING STEPS- EQUINE CENTERED THERAPY LLC.
Entity type:Organization
Organization Name:HEALING STEPS- EQUINE CENTERED THERAPY LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:KELSEY
Authorized Official - Middle Name:E
Authorized Official - Last Name:HERMAN
Authorized Official - Suffix:
Authorized Official - Credentials:OTD, OTR/L
Authorized Official - Phone:360-771-3556
Mailing Address - Street 1:14708 NE 100TH AVE
Mailing Address - Street 2:
Mailing Address - City:BRUSH PRAIRIE
Mailing Address - State:WA
Mailing Address - Zip Code:98606-9300
Mailing Address - Country:US
Mailing Address - Phone:360-771-3556
Mailing Address - Fax:360-576-5043
Practice Address - Street 1:14708 NE 100TH AVE
Practice Address - Street 2:
Practice Address - City:BRUSH PRAIRIE
Practice Address - State:WA
Practice Address - Zip Code:98606-9300
Practice Address - Country:US
Practice Address - Phone:360-771-3556
Practice Address - Fax:360-576-5043
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-06-02
Last Update Date:2023-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAOT60999392OtherOT LICENSE