Healthcare Provider Details

I. General information

NPI: 1396768701
Provider Name (Legal Business Name): KRISTIN M ZINN MS, PT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KRISTIN M BERGQUIST MS, PT

II. Dates (important events)

Enumeration Date: 07/26/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

19319 7TH AVE NE STE 114
POULSBO WA
98370-7442
US

IV. Provider business mailing address

19319 7TH AVE NE STE 114
POULSBO WA
98370-7442
US

V. Phone/Fax

Practice location:
  • Phone: 360-697-2228
  • Fax: 360-697-2116
Mailing address:
  • Phone: 360-697-2228
  • Fax: 360-697-2116

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2251P0200X
TaxonomyPediatric Physical Therapist
License NumberPT00005861
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: