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NPI 1013773647

NPI 1013773647 : KAMILAH KENT PT : TACOMA, WA

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General NPI Number Information
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    NPI Number           |    1013773647
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    Entity Type          |    Individual 
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    Provider Name        |    KAMILAH KENT PT
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    02/21/2024
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    Last Update Date     |    02/21/2024
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Provider Practice Location Address
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    Address Line         |    1407 E 72ND ST STE A100 
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    City                 |    TACOMA
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    State                |    WA
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    Zip                  |    98404-5906
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    Country              |    US
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    Telephone            |    253-474-7474
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    31511 106TH PL SE APT T102 
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    City                 |    AUBURN
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    State                |    WA
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    Zip                  |    98092-3050
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    Country              |    US
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    Telephone            |    
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    Fax                  |    
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    225100000X
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    Taxonomy Name        |    Physical Therapist
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    License Number       |    PT61501520
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    License Number State |    WA
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