Provider Demographics
NPI:1841907847
Name:BLOOMING PEDIATRIC THERAPY, PLLC
Entity type:Organization
Organization Name:BLOOMING PEDIATRIC THERAPY, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OCCUPATIONAL THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:YULING
Authorized Official - Middle Name:
Authorized Official - Last Name:LIU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:425-292-2208
Mailing Address - Street 1:PO BOX 135
Mailing Address - Street 2:
Mailing Address - City:LYNNWOOD
Mailing Address - State:WA
Mailing Address - Zip Code:98046-0135
Mailing Address - Country:US
Mailing Address - Phone:425-292-2208
Mailing Address - Fax:425-364-4135
Practice Address - Street 1:6817 208TH ST SW UNIT 135
Practice Address - Street 2:
Practice Address - City:LYNNWOOD
Practice Address - State:WA
Practice Address - Zip Code:98046-4606
Practice Address - Country:US
Practice Address - Phone:425-292-2208
Practice Address - Fax:425-364-4135
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-10-31
Last Update Date:2025-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatricsGroup - Single Specialty