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NPI Code Detail

MEDICARE: MS. RUTH KNAGENHJELM PT

MEDICARE: MS. RUTH KNAGENHJELM 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 Therapist2519WA

General Provider Information

NPI Number : 1669589503
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. RUTH KNAGENHJELM PT
Provider Business Mailing Address
First Line : 181 S 333RD ST STE 250
Second Line :
City : FEDERAL WAY
State : WA
Zip : 98003-7363
Country : US
Telephone Number : 253-874-2998
Fax Number : 253-874-3307
Provider Business Practice Location Address
First Line : 22659 PACIFIC HWY S
Second Line :
City : DES MOINES
State : WA
Zip : 98198-5155
Country : US
Telephone Number : 206-824-3668
Fax Number : 206-824-3964
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/24/2006
Last Update Date : 04/22/2014

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