NPIMap

Organization Active NPI

Wonderland Child & Family Services

  • Developmental Disabilities Clinic/Center
  • Shoreline, WA
National Provider Identifier
1003478660
Registry record updated Aug 16, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Developmental Disabilities Clinic/CenterTaxonomy code 261QD1600X
Legal business name
WONDERLAND CHILD & FAMILY SERVICES
Practice address
2402 NW 195TH PL
Shoreline, WA 98177-2932
Phone
(206) 364-3777
Fax
(206) 364-3999
NPI assigned
Jul 3, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 16, 2019

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Kristi Johnson
Title
Billing Specialist
Phone
(206) 364-3777

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 1041C0700X
Pediatric Physical TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 2251P0200X
Occupational TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225X00000X
Speech-Language PathologistGroup: 193200000X MULTI-SPECIALTY GROUP 235Z00000X
Developmental Disabilities Clinic/Center 261QD1600X Primary

Addresses

Primary practice location

2402 NW 195TH PL
Shoreline, WA 98177-2932

Mailing address

1909 214TH St SE Ste 204
Bothell, WA 98021-4415
Phone (425) 219-4788

Other practice location 1

1909 214th St SE Ste 204
Bothell, WA 98021-4415
Phone (425) 219-4788

Other identifiers 1

IdentifierTypeStateIssuer
768265MedicaidWA

Other names 1

  • Wonderland Developmental Center Former legal business name

National Provider Directory

National Provider Directory
Tax ID family
Hope Rising Clinic2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

2402 NW 195th Pl
Shoreline, WA 98177
Phone (206) 364-3777

Practitioners & affiliated clinicians

Practitioners 41

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 41

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1562112000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1565913600000",
    "number": "1003478660",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1909 214TH ST SE STE 204",
            "city": "BOTHELL",
            "state": "WA",
            "postal_code": "980214415",
            "telephone_number": "425-219-4788",
            "fax_number": "425-219-4790"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2402 NW 195TH PL",
            "city": "SHORELINE",
            "state": "WA",
            "postal_code": "981772932",
            "telephone_number": "206-364-3777",
            "fax_number": "206-364-3999"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1909 214th St SE Ste 204",
            "address_purpose": "LOCATION",
            "city": "Bothell",
            "state": "WA",
            "postal_code": "980214415",
            "country_code": "US",
            "telephone_number": "425-219-4788",
            "fax_number": "425-219-4790",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "WONDERLAND CHILD & FAMILY SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-07-03",
        "last_updated": "2019-08-16",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "KRISTI",
        "authorized_official_title_or_position": "BILLING SPECIALIST",
        "authorized_official_telephone_number": "206-364-3777"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2251P0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist, Pediatrics",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QD1600X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "768265",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Wonderland Developmental Center",
            "code": "4",
            "type": "Former Legal Business Name"
        },
        {
            "organization_name": "Wonderland Developmental Center",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Shoreline, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.