Organization
WILDFLOWER PEDIATRIC THERAPY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LAURA MOE OTR/L (OCCUPATIONAL THERAPIST)
(503) 803-3375
Entity
Organization
Contact information
Practice address
304 N 34TH AVE, YAKIMA, WA 98902-2220
(503) 803-3375
Mailing address
304 N 34TH AVE, YAKIMA, WA 98902-2220
(503) 803-3375
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
60772125
WA
Other
Enumeration date
07/10/2018
Last updated
07/10/2018
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