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NPI Code Detail

MEDICARE: WINTHROP PT, PS

MEDICARE: WINTHROP PT, PS
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 TherapistPT60290704WA

General Provider Information

NPI Number : 1710397658
Entity Type Code : Organization
Provider Name (Legal Business Name) : WINTHROP PT, PS
Provider Business Mailing Address
First Line : PO BOX 814
Second Line :
City : WINTHROP
State : WA
Zip : 98862-0814
Country : US
Telephone Number : 509-996-8234
Fax Number : 509-996-2193
Provider Business Practice Location Address
First Line : 202 WHITE AVE
Second Line :
City : WINTHROP
State : WA
Zip : 98862-9774
Country : US
Telephone Number : 509-996-8234
Fax Number : 509-996-2193
Authorized Official
Title or Position : OWNER
Name : JENNA L KOKES
Credential : DPT
Telephone Number : 509-996-8234
Provider Enumeration Date : 04/30/2014
Last Update Date : 04/30/2014

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Directions to “WINTHROP PT, PS ” Practice Location

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