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General NPI Number Information
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NPI Number | 1063387041
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Entity Type | Individual
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Provider Name | KIRAH BOYNTON-BROWN DPT, PT
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Gender |
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Dates
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Enumeration Date | 10/08/2025
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Last Update Date | 10/08/2025
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Provider Practice Location Address
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Address Line | 16111 SE MCGILLIVRAY BLVD STE A
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City | VANCOUVER
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State | WA
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Zip | 98683-9033
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Country | US
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Telephone | 360-253-4020
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Fax |
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Provider Business Mailing Address
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Address Line | 14119 SE BELLA VISTA CIR
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City | VANCOUVER
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State | WA
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Zip | 98683-7744
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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 | 2251X0800X
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Taxonomy Name | Orthopedic Physical Therapist
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License Number | 70037305
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License Number State | WA
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