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General NPI Number Information
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NPI Number | 1043994569
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Entity Type | Individual
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Provider Name | KRISTEN MACKIE TRIQUET DPT
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Gender | Female
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Dates
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Enumeration Date | 06/14/2023
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Last Update Date | 02/28/2025
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Provider Practice Location Address
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Address Line | 2930 S MERIDIAN STE 120
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City | PUYALLUP
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State | WA
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Zip | 98373-1654
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Country | US
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Telephone | 253-445-2733
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Fax |
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Provider Business Mailing Address
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Address Line | 461 POND APPLE RD
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City | CLARKSVILLE
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State | TN
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Zip | 37043-2208
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Country | US
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Telephone | 978-417-1834
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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 | 16329
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License Number State | TN
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Taxonomy #2
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | PT61443440
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License Number State | WA
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