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General NPI Number Information
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NPI Number | 1992714265
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Entity Type | Individual
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Provider Name | KENNETH EVAN PAINTER PT
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Gender | Male
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Dates
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Enumeration Date | 08/05/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 1660 S COLUMBIAN WAY # RCS-117-S
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City | SEATTLE
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State | WA
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Zip | 98108-1532
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Country | US
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Telephone | 206-762-1010
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Fax |
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Provider Business Mailing Address
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Address Line | 20323 98TH AVE NE
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City | BOTHELL
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State | WA
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Zip | 98011-2314
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Country | US
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Telephone | 425-806-0836
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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 | PT00006642
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License Number State | WA
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