Healthcare Provider Details

I. General information

NPI: 1558490946
Provider Name (Legal Business Name): KRISTIE FAY BJORNSON PHD, PT, MS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/03/2007
Last Update Date: 12/30/2020
Certification Date: 12/30/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3821 NE 93RD ST
SEATTLE WA
98115-3752
US

IV. Provider business mailing address

3821 NE 93RD ST
SEATTLE WA
98115-3752
US

V. Phone/Fax

Practice location:
  • Phone: 425-830-4188
  • Fax:
Mailing address:
  • Phone: 425-830-4188
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT00003004
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: