Provider Demographics
NPI:1114788106
Name:PLAY TO LEARN OCCCUPATIONAL THERAPY
Entity type:Organization
Organization Name:PLAY TO LEARN OCCCUPATIONAL THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/THERAPIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:REBECCA
Authorized Official - Middle Name:
Authorized Official - Last Name:PETERSON
Authorized Official - Suffix:
Authorized Official - Credentials:OTR/L
Authorized Official - Phone:206-660-0471
Mailing Address - Street 1:4314 SE 42ND AVE
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97206-4176
Mailing Address - Country:US
Mailing Address - Phone:206-660-0471
Mailing Address - Fax:971-888-5266
Practice Address - Street 1:1620 SE CLAYBOURNE ST STE A106
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97202-5662
Practice Address - Country:US
Practice Address - Phone:503-752-0711
Practice Address - Fax:971-888-5266
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-17
Last Update Date:2025-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD1600XAmbulatory Health Care FacilitiesClinic/CenterDevelopmental Disabilities