NPIMap

Organization Active NPI

Wildflower Pediatric Therapy LLC

  • Pediatric Occupational Therapist
  • Yakima, WA
National Provider Identifier
1063908382
Registry record updated Jul 10, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Occupational TherapistTaxonomy code 225XP0200X
License
60772125 Issued in WA
Legal business name
WILDFLOWER PEDIATRIC THERAPY LLC
Practice address
304 N 34TH Ave
Yakima, WA 98902-2220
Phone
(503) 803-3375
NPI assigned
Jul 10, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 10, 2018

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

Authorized official

Name
Laura Moe, OTR/LNPI 1275935413
Title
Occupational Therapist
Phone
(503) 803-3375

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Occupational TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225XP0200X 60772125 WA Primary

Addresses

Primary practice location

304 N 34TH Ave
Yakima, WA 98902-2220

Mailing address

304 N 34TH Ave
Yakima, WA 98902-2220
Phone (503) 803-3375

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1531180800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1531180800000",
    "number": "1063908382",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "304 N 34TH AVE",
            "city": "YAKIMA",
            "state": "WA",
            "postal_code": "989022220",
            "telephone_number": "503-803-3375"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "304 N 34TH AVE",
            "city": "YAKIMA",
            "state": "WA",
            "postal_code": "989022220",
            "telephone_number": "503-803-3375"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WILDFLOWER PEDIATRIC THERAPY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-07-10",
        "last_updated": "2018-07-10",
        "status": "A",
        "authorized_official_last_name": "MOE",
        "authorized_official_first_name": "LAURA",
        "authorized_official_title_or_position": "OCCUPATIONAL THERAPIST",
        "authorized_official_telephone_number": "503-803-3375",
        "authorized_official_credential": "OTR/L"
    },
    "taxonomies": [
        {
            "code": "225XP0200X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "WA",
            "license": "60772125",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Yakima, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2018; 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.