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1063565620

NPI Code Detail

MEDICARE: KRISTEN S VAN DINTER PT

MEDICARE: KRISTEN S VAN DINTER PT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	PT00008369	WA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	P00325142	OTHER	WA	RAILROAD MC#
3	0039585	OTHER	WA	LABOR AND INDUSTRIES #
4	2241VA	OTHER	WA	BLUE SHIELD#
5	US2456218	OTHER	WA	AETNA SPECIALIST PIN

General Provider Information

NPI Number	:	1063565620
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KRISTEN S VAN DINTER PT

Provider Business Mailing Address
First Line	:	7900 E GREEN LAKE DR N
Second Line	:	SUITE 204
City	:	SEATTLE
State	:	WA
Zip	:	98103-4800
Country	:	US
Telephone Number	:	206-985-2236
Fax Number	:

Provider Business Practice Location Address
First Line	:	7900 E GREEN LAKE DR N
Second Line	:	SUITE 204
City	:	SEATTLE
State	:	WA
Zip	:	98103-4800
Country	:	US
Telephone Number	:	206-985-2236
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/18/2007
Last Update Date	:	08/29/2008

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Directions to “ KRISTEN S VAN DINTER PT” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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