Healthcare Provider Details

I. General information

NPI: 1649124470
Provider Name (Legal Business Name): MOVE WITH ME KIDS PT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/26/2026
Last Update Date: 02/26/2026
Certification Date: 02/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

108 UNION AVE
SNOHOMISH WA
98290
US

IV. Provider business mailing address

1429 AVENUE D # 504
SNOHOMISH WA
98290-1742
US

V. Phone/Fax

Practice location:
  • Phone: 360-386-5059
  • Fax: 360-682-0634
Mailing address:
  • Phone: 360-386-5059
  • Fax: 360-682-0634

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: KELLY DANIELS
Title or Position: OWNER, PHYSICAL THERAPIST
Credential: PT
Phone: 360-386-5059