NPIMap

Organization Active NPI

Eastside Children's Therapy

  • Pediatric Occupational Therapist
  • Issaquah, WA
National Provider Identifier
1902808942
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Occupational TherapistTaxonomy code 225XP0200X
License
OT00000808 Issued in WA
Legal business name
EASTSIDE CHILDREN'S THERAPY
Practice address
710 NW Juniper St
Suite 106
Issaquah, WA 98027-2717
Phone
(425) 392-2346
Fax
(425) 392-0185
NPI assigned
Aug 10, 2005
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Viktoria Littleman, OTR/L
Title
Owner
Phone
(425) 392-2346

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Occupational Therapist 225XP0200X OT00000808 WA Primary

Addresses

Primary practice location

710 NW Juniper St
Suite 106
Issaquah, WA 98027-2717

Mailing address

PO Box 819
Orting, WA 98360-0819
Phone (360) 893-6576

Other identifiers 2

IdentifierTypeStateIssuer
1821EAOtherWAREGENCE BLUE SHIELD GRP
7680648MedicaidWA

National Provider Directory

National Provider Directory

Locations

710 NW Juniper St
Ste 106
Issaquah, WA 98027
Phone (425) 392-2346

Practitioners & affiliated clinicians

Practitioners 13

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 13

NPI Registry JSON

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

{
    "created_epoch": "1123632000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1902808942",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 819",
            "city": "ORTING",
            "state": "WA",
            "postal_code": "983600819",
            "telephone_number": "360-893-6576",
            "fax_number": "360-893-6506"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "710 NW JUNIPER ST",
            "address_2": "SUITE 106",
            "city": "ISSAQUAH",
            "state": "WA",
            "postal_code": "980272717",
            "telephone_number": "425-392-2346",
            "fax_number": "425-392-0185"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EASTSIDE CHILDREN'S THERAPY",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-08-10",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "LITTLEMAN",
        "authorized_official_first_name": "VIKTORIA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "425-392-2346",
        "authorized_official_credential": "OTR/L"
    },
    "taxonomies": [
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "WA",
            "license": "OT00000808",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGENCE BLUE SHIELD GRP",
            "identifier": "1821EA",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7680648",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Issaquah, WA

Sources for this page

  • 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.