Healthcare Provider Details

I. General information

NPI: 1114925948
Provider Name (Legal Business Name): WILLIAM WALTER LINNENKOHL M.P.T.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/14/2005
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2755 MOTTMAN RD SW
TUMWATER WA
98512-5684
US

IV. Provider business mailing address

2755 MOTTMAN RD SW
TUMWATER WA
98512-5684
US

V. Phone/Fax

Practice location:
  • Phone: 360-352-5077
  • Fax: 360-352-5022
Mailing address:
  • Phone: 360-352-5077
  • Fax: 360-352-5022

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT00002430 WA
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code2251N0400X
TaxonomyNeurology Physical Therapist
License NumberPT00002430 WA
License Number StateWA
# 3
Primary TaxonomyN
Taxonomy Code2251S0007X
TaxonomySports Physical Therapist
License NumberPT00002430 WA
License Number StateWA
# 4
Primary TaxonomyY
Taxonomy Code2251X0800X
TaxonomyOrthopedic Physical Therapist
License NumberPT00002430 WA
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: