Healthcare Provider Details

I. General information

NPI: 1295719698
Provider Name (Legal Business Name): KATHRYN MABEL HAHN PHYSICAL THERAPIST
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KATHRYN HAHN BRANSON PHYSICAL THERAPIST

II. Dates (important events)

Enumeration Date: 11/30/2005
Last Update Date: 09/19/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2611 NE 125TH ST TAI NORTHLAKE PHYSICAL THERAPY STE 140
SEATTLE WA
98125-4357
US

IV. Provider business mailing address

11481 SW HALL BLVD THERAPEUTIC ASSOCIATES INC STE 201
PORTLAND OR
97223-8403
US

V. Phone/Fax

Practice location:
  • Phone: 206-361-4745
  • Fax: 206-361-4877
Mailing address:
  • Phone: 800-219-8835
  • Fax: 503-443-1402

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT00003168
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number10730-24
License Number StateWI
# 3
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: