NPIMap

Organization Active NPI

Sky Bridge Therapies LLC

  • Developmental Disabilities Clinic/Center
  • Lakewood, WA
National Provider Identifier
1356855530
Registry record updated Mar 18, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Developmental Disabilities Clinic/CenterTaxonomy code 261QD1600X
Legal business name
SKY BRIDGE THERAPIES LLC
Practice address
9307 Bridgeport Way SW
Lakewood, WA 98499-1570
Phone
(516) 510-5963
NPI assigned
Nov 26, 2017
Last updated
Mar 18, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 18, 2021

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

Authorized official

Name
Cynthia Bonilla, MOTR/L
Title
Occupational Therapy Dept. Head
Phone
(253) 201-1234

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X NU
Speech-Language Pathologist 235Z00000X NU
Developmental Disabilities Clinic/Center 261QD1600X NU Primary
Hearing and Speech Clinic/Center 261QH0700X NU

Addresses

Primary practice location

9307 Bridgeport Way SW
Lakewood, WA 98499-1570

Mailing address

9124 Gravelly Lake Dr SW Ste 102
Lakewood, WA 98499-3198
Phone (253) 201-1234

National Provider Directory

National Provider Directory

Locations

9124 Gravelly Lake Dr SW
Ste 102
Lakewood, WA 98499

9307 Bridgeport Way SW
Tacoma, WA 98499
Phone (253) 201-1234

Practitioners & affiliated clinicians

Practitioners 29

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 29

NPI Registry JSON

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

{
    "created_epoch": "1511654400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1616025600000",
    "number": "1356855530",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9124 GRAVELLY LAKE DR SW STE 102",
            "city": "LAKEWOOD",
            "state": "WA",
            "postal_code": "984993198",
            "telephone_number": "253-201-1234",
            "fax_number": "253-235-4201"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9307 BRIDGEPORT WAY SW",
            "city": "LAKEWOOD",
            "state": "WA",
            "postal_code": "984991570",
            "telephone_number": "516-510-5963"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SKY BRIDGE THERAPIES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-11-26",
        "last_updated": "2021-03-18",
        "certification_date": "2021-03-18",
        "status": "A",
        "authorized_official_last_name": "BONILLA",
        "authorized_official_first_name": "CYNTHIA",
        "authorized_official_title_or_position": "OCCUPATIONAL THERAPY DEPT. HEAD",
        "authorized_official_telephone_number": "253-201-1234",
        "authorized_official_credential": "MOTR/L"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "261QD1600X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Developmental Disabilities",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "261QH0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Hearing and Speech",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakewood, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2021; 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.