MEDICARE: DR. STEVEN KENNETH KORTHUIS DPT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	PT00007181	WA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	PT00007181	OTHER	WA	WA STATE PT LICENSE

General Provider Information

NPI Number	:	1154306967
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. STEVEN KENNETH KORTHUIS DPT

Provider Business Mailing Address
First Line	:	1824 FRONT ST STE A
Second Line	:
City	:	LYNDEN
State	:	WA
Zip	:	98264-1729
Country	:	US
Telephone Number	:	360-354-0585
Fax Number	:	360-354-1098

Provider Business Practice Location Address
First Line	:	1824 FRONT ST
Second Line	:	STE A
City	:	LYNDEN
State	:	WA
Zip	:	98264-1729
Country	:	US
Telephone Number	:	360-354-0585
Fax Number	:	360-354-1098

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/14/2005
Last Update Date	:	01/12/2026

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