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1225829831 NPI number — KAITLYNN JO ANDERSON PT, DPT, CSCS

NPI Number: 1225829831
Health Care Provider/Practitioner: KAITLYNN JO ANDERSON PT, DPT, CSCS

Information about “1225829831” NPI (KAITLYNN JO ANDERSON PT, DPT, CSCS) exists in 1225829831 in HTML format HTML  |  1225829831 in plain Text format TXT  |  1225829831 in PDF (Portable Document Format) PDF  |  1225829831 in an XML format XML  formats.

NPI Number : 1225829831 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1225829831",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "ANDERSON",
    "FirstName": "KAITLYNN",
    "MiddleName": "JO",
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": "PT, DPT, CSCS",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "1023 E HAWK CT",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "SPOKANE",
    "MailingAddressStateName": "WA",
    "MailingAddressPostalCode": "99208-7561",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "509-475-9061",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "9310 N DIVISION ST",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "SPOKANE",
    "PracticeLocationAddressStateName": "WA",
    "PracticeLocationAddressPostalCode": "99218-1227",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "509-789-2836",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "05/14/2025",
    "LastUpdateDate": "05/14/2025",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "F",
    "Gender": "Female",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "2251X0800X",
        "TaxonomyName": "Orthopedic Physical Therapist",
        "LicenseNumber": null,
        "LicenseNumberStateCode": null,
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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