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General NPI Number Information
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NPI Number | 1548000698
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Entity Type | Individual
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Provider Name | CEILI MONIQUE YSABEL KACMARCIK DPT
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Gender | Female
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Dates
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Enumeration Date | 05/28/2024
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Last Update Date | 05/28/2024
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Provider Practice Location Address
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Address Line | 12911 120TH AVE NE STE F120
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City | KIRKLAND
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State | WA
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Zip | 98034-3025
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Country | US
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Telephone | 425-305-2940
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Fax |
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Provider Business Mailing Address
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Address Line | 18420 102ND AVE NE APT 223
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City | BOTHELL
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State | WA
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Zip | 98011-3524
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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 | 2251S0007X
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Taxonomy Name | Sports Physical Therapist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 2251X0800X
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Taxonomy Name | Orthopedic Physical Therapist
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number |
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License Number State | WA
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