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General NPI Number Information
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NPI Number | 1144788928
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Entity Type | Individual
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Provider Name | KENDALL HOLLIS
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Gender | Female
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Dates
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Enumeration Date | 03/11/2019
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Last Update Date | 04/21/2020
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Provider Practice Location Address
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Address Line | 1717 S J ST
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City | TACOMA
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State | WA
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Zip | 98405-4933
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Country | US
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Telephone | 253-426-4400
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Fax |
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Provider Business Mailing Address
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Address Line | 805 S STEELE ST
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City | TACOMA
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State | WA
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Zip | 98405-3047
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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 | 60094471
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License Number State | WA
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