Healthcare Provider Details
I. General information
NPI: 1962956938
Provider Name (Legal Business Name): KIRSTEN MARIE KUYKENDALL PT, DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 08/08/2016
Last Update Date: 08/08/2016
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
3601 FREMONT AVE N STE 414
SEATTLE WA
98103-8753
US
IV. Provider business mailing address
3601 FREMONT AVE N STE 414
SEATTLE WA
98103-8753
US
V. Phone/Fax
- Phone: 206-548-1522
- Fax:
- Phone: 206-548-1522
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2251X0800X |
| Taxonomy | Orthopedic Physical Therapist |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: