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NPI Code Detail

MEDICARE: KATHARINE SUZANNE HAYNER PT

MEDICARE: KATHARINE SUZANNE HAYNER 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
1225100000XPhysical TherapistPT00003182WA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1205811791
Entity Type Code : Individual
Provider Name (Legal Business Name) : KATHARINE SUZANNE HAYNER PT
Provider Business Mailing Address
First Line : 11481 SW HALL BLVD
Second Line : STE 201
City : PORTLAND
State : OR
Zip : 97223-8403
Country : US
Telephone Number : 800-219-8835
Fax Number : 503-443-1402
Provider Business Practice Location Address
First Line : 4701 41ST AVE SW
Second Line : STE 100
City : SEATTLE
State : WA
Zip : 98116-4597
Country : US
Telephone Number : 206-932-8363
Fax Number : 206-932-4973
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/07/2005
Last Update Date : 11/07/2007

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