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General NPI Number Information
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NPI Number | 1922627900
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Entity Type | Individual
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Provider Name | GRANT KINNEE PT, DPT
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Gender | Male
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Dates
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Enumeration Date | 04/10/2020
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Last Update Date | 04/10/2020
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Provider Practice Location Address
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Address Line | 5939 S 149TH ST
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City | TUKWILA
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State | WA
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Zip | 98168-4612
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Country | US
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Telephone | 206-901-7562
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Fax |
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Provider Business Mailing Address
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Address Line | 9112 32ND AVE NE
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City | SEATTLE
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State | WA
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Zip | 98115-3517
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Country | US
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Telephone | 925-858-0070
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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 | 60992177
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License Number State | WA
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