# FUNCTIONAL FOUNDATIONS PEDIATRIC SERVICES

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1437926789
- **Authorized official:** SOPHIA PATEL PT (EXECUTIVE DIRECTOR)
- **Authorized official phone:** (541) 255-6400

## Contact information

- **Practice address:** 3575 DONALD ST STE 300, EUGENE, OR 97405-4700
- **Practice address phone:** (541) 255-6400
- **Practice address fax:** (458) 221-4205
- **Mailing address:** 3575 DONALD ST STE 300, EUGENE, OR 97405-4700
- **Mailing address phone:** (541) 255-6400
- **Mailing address fax:** (458) 221-4205

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 225100000X | Physical Therapist | — | NULL | Yes |
| 225100000X | Physical Therapist | — | — | Yes |
| 225X00000X | Occupational Therapist | — | NULL | — |
| 225X00000X | Occupational Therapist | — | — | — |
| 235Z00000X | Speech-Language Pathologist | — | NULL | — |
| 235Z00000X | Speech-Language Pathologist | — | — | — |

## Other

- **Enumeration date:** 12/06/2023
- **Last updated:** 12/06/2023