Early Choice Pediatric Therapy, PLLC

Primary specialty

Developmental Disabilities Clinic/CenterTaxonomy code 261QD1600X

Legal business name

EARLY CHOICE PEDIATRIC THERAPY, PLLC

Practice address

106 E 15TH St
Vancouver, WA 98663-3401

Phone

(360) 750-5850

Fax

(360) 750-7244

NPI assigned

Nov 12, 2006

Organization subpart

No

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

Authorized official

Name

Ms. Robin Lysane Pelletier, PT, MPTNPI 1568533628

Title

Executive Director

Phone

(360) 750-5850

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 2

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

• Robin Lysane Pelletier, PT, MPT

  • Physical Therapist
  • Vancouver, WA
  • NPI 1568533628
  NPD (past) Authorized official
• Kelly L Engebo, M.A.,SLP,CCC

  • Speech-Language Pathologist
  • Vancouver, WA
  • NPI 1457411001
  NPD (past)

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

{
    "created_epoch": "1163289600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1114098274",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "208 W 36TH ST",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986601936",
            "telephone_number": "360-750-5850",
            "fax_number": "360-750-7244"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "106 E 15TH ST",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986633401",
            "telephone_number": "360-750-5850",
            "fax_number": "360-750-7244"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EARLY CHOICE PEDIATRIC THERAPY, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-12",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "PELLETIER",
        "authorized_official_first_name": "ROBIN",
        "authorized_official_middle_name": "LYSANE",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "360-750-5850",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "PT, MPT"
    },
    "taxonomies": [
        {
            "code": "261QD1600X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8335184",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Cynthia Eagon, LMP
• Ellen M Eakins, LMP
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• Lauren Earle, LMHC
• Mara Earls
• Cynthia Marie Easley, RD, LD, CDE
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• Developmental Disabilities Clinic/Center in Vancouver, WA
• Providers in Vancouver, WA by specialty
• Developmental Disabilities Clinic/Center in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.