Healthcare Provider Details

I. General information

NPI: 1851626220
Provider Name (Legal Business Name): KATHRYN E REYNOLDS DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/02/2009
Last Update Date: 12/04/2025
Certification Date: 12/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

104 W 9TH AVE
POST FALLS ID
83854-9216
US

IV. Provider business mailing address

104 W 9TH AVE
POST FALLS ID
83854-9216
US

V. Phone/Fax

Practice location:
  • Phone: 208-777-9740
  • Fax: 208-777-8316
Mailing address:
  • Phone: 208-777-9740
  • Fax: 208-777-8316

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT60102172
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT-2971670
License Number StateID

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: