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Organization
SPROUT CLUBHOUSE
Active
Organization
SPROUT CLUBHOUSE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KRISTOPHER L MCGREW (CFO)
(206) 954-6593
Entity
Organization
Contact information
Practice address
7223 NE 118TH CT, KIRKLAND, WA 98034-2445
(425) 269-1833
Mailing address
7223 NE 118TH CT, KIRKLAND, WA 98034-2445
(425) 269-1833
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
NULL
103K00000X
Behavior Analyst
Primary
—
—
225X00000X
Occupational Therapist
—
NULL
225X00000X
Occupational Therapist
—
—
235Z00000X
Speech-Language Pathologist
—
NULL
235Z00000X
Speech-Language Pathologist
—
—
Other
Enumeration date
03/02/2022
Last updated
03/02/2022
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