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General NPI Number Information
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NPI Number | 1164331922
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Entity Type | Individual
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Provider Name | KRISTIN JOSEPHINE KANKELBORG PT
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Gender | Female
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Dates
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Enumeration Date | 09/05/2026
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Last Update Date | 09/05/2026
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Provider Practice Location Address
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Address Line | 7727 40TH ST W
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City | UNIVERSITY PLACE
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State | WA
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Zip | 98466-3146
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Country | US
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Telephone | 253-460-1362
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Fax |
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Provider Business Mailing Address
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Address Line | 5401 N COURT ST UNIT B
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City | RUSTON
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State | WA
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Zip | 98407-3104
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Country | US
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Telephone | 253-432-0800
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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 | PT.PT.70169386
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License Number State | WA
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