Organization
CHILDREN'S THERAPY CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BARRY GOURLEY (EXECUTIVE DIRECTOR)
(253) 854-5660
Entity
Organization
Contact information
Practice address
10811 SE KENT KANGLEY RD, KENT, WA 98030-7108
(253) 854-5660
(253) 854-7025
Mailing address
10811 SE KENT KANGLEY RD, KENT, WA 98030-7108
(253) 854-5660
(253) 854-7025
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
335E00000X
Prosthetic/Orthotic Supplier
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7018518
—
WA
Enumeration date
01/25/2007
Last updated
04/12/2018
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