Healthcare Provider Details

I. General information

NPI: 1962643965
Provider Name (Legal Business Name): REDMOND PHYSICAL THERAPY, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/20/2009
Last Update Date: 08/25/2025
Certification Date: 08/25/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12911 120TH AVE NE STE F120
KIRKLAND WA
98034-3025
US

IV. Provider business mailing address

16261 REDMOND WAY STE 100
REDMOND WA
98052-3833
US

V. Phone/Fax

Practice location:
  • Phone: 425-305-2940
  • Fax: 425-881-3585
Mailing address:
  • Phone: 425-881-3001
  • Fax: 425-881-3585

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State

VIII. Authorized Official

Name: MR. KENNETH CRINKLAW
Title or Position: PRESIDENT
Credential: MSPT, OCS
Phone: 425-881-3001