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NPI Code Detail

MEDICARE: KAYATHRIDEVI KRISHNASAMY

MEDICARE: KAYATHRIDEVI KRISHNASAMY
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
1261QP2000XPhysical Therapy Clinic/CenterPT.PT.60337161WA

General Provider Information

NPI Number : 1760315295
Entity Type Code : Individual
Provider Name (Legal Business Name) : KAYATHRIDEVI KRISHNASAMY
Provider Business Mailing Address
First Line : 2000 BUTTERFIELD RD STE 1600
Second Line :
City : DOWNERS GROVE
State : IL
Zip : 60515-1055
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 405 NW GILMAN BLVD STE 200
Second Line :
City : ISSAQUAH
State : WA
Zip : 98027-2470
Country : US
Telephone Number : 425-392-6804
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/04/2026
Last Update Date : 06/04/2026

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Directions to “ KAYATHRIDEVI KRISHNASAMY ” Practice Location

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