Healthcare Provider Details

I. General information

NPI: 1740707512
Provider Name (Legal Business Name): MONICA HURST DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/23/2017
Last Update Date: 02/19/2025
Certification Date: 02/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

25989 BARBER CUT OFF RD NE
KINGSTON WA
98346-8455
US

IV. Provider business mailing address

PO BOX 960
BREMERTON WA
98337-0212
US

V. Phone/Fax

Practice location:
  • Phone: 360-377-3776
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number1291928
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA.PA.61452484
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: