Provider Demographics
NPI: | 1831076934 |
---|---|
Name: | PLAYGROUND PEDIATRIC OCCUPATIONAL THERAPY |
Entity type: | Organization |
Organization Name: | PLAYGROUND PEDIATRIC OCCUPATIONAL THERAPY |
Other - Org Name: | |
Other - Org Type: | |
Authorized Official - Title/Position: | OWNER |
Authorized Official - Prefix: | |
Authorized Official - First Name: | TIFFANY |
Authorized Official - Middle Name: | MARIE |
Authorized Official - Last Name: | CUNNINGHAM |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | |
Authorized Official - Phone: | 206-915-3890 |
Mailing Address - Street 1: | 641 S STEELE ST |
Mailing Address - Street 2: | |
Mailing Address - City: | TACOMA |
Mailing Address - State: | WA |
Mailing Address - Zip Code: | 98405-3045 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 206-915-3890 |
Mailing Address - Fax: | |
Practice Address - Street 1: | 641 S STEELE ST |
Practice Address - Street 2: | |
Practice Address - City: | TACOMA |
Practice Address - State: | WA |
Practice Address - Zip Code: | 98405-3045 |
Practice Address - Country: | US |
Practice Address - Phone: | 206-915-3890 |
Practice Address - Fax: | |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2025-08-19 |
Last Update Date: | 2025-08-19 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization | Group |
---|---|---|---|---|---|
Yes | 225XP0200X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist | Pediatrics | Group - Multi-Specialty |