Organization
EASTSIDE CHILDREN'S THERAPY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
VIKTORIA LITTLEMAN OTR/L (OWNER)
(425) 392-2346
Entity
Organization
Contact information
Practice address
710 NW JUNIPER ST, SUITE 106, ISSAQUAH, WA 98027-2717
(425) 392-2346
(425) 392-0185
Mailing address
PO BOX 819, ORTING, WA 98360-0819
(360) 893-6576
(360) 893-6506
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
OT00000808
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1821EA
REGENCE BLUE SHIELD GRP
WA
05
—
7680648
—
WA
Enumeration date
08/10/2005
Last updated
08/22/2020
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