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General NPI Number Information
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NPI Number | 1932908837
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Entity Type | Organization
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Legal Business Name | HENRICKSEN PHYSICAL THERAPY PLLC
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Dates
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Enumeration Date | 03/12/2025
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Last Update Date | 04/28/2025
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Provider Practice Location Address
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Address Line | 3721 GRIFFIN LN SE STE 101
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City | OLYMPIA
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State | WA
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Zip | 98501-2192
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Country | US
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Telephone | 360-789-5384
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Fax |
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Provider Business Mailing Address
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Address Line | 4250 MARTIN WAY E STE 105 PMB 236
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City | OLYMPIA
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State | WA
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Zip | 98516-5317
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Country | US
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Telephone | 360-789-5384
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Fax | 360-918-9713
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Authorized Official
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Title or Position | OWNER / MANAGER /PHYSICAL THERAPIST
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Name | KELLI HENRICKSEN
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Credential | DPT
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Telephone | 360-789-5384
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number |
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License Number State |
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