Healthcare Provider Details

I. General information

NPI: 1336901487
Provider Name (Legal Business Name): KIARA CONNIE ABRAMS DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/24/2024
Last Update Date: 07/24/2024
Certification Date: 07/24/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

21651 E COUNTRY VISTA DR
LIBERTY LAKE WA
99019-7708
US

IV. Provider business mailing address

21651 E COUNTRY VISTA DR
LIBERTY LAKE WA
99019-7708
US

V. Phone/Fax

Practice location:
  • Phone: 509-822-7834
  • Fax:
Mailing address:
  • Phone: 509-822-7834
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number61447345
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number27137
License Number StateMT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: