| |
7215 116th Ave Se, Newcastle, WA 98056-1102 | |
(360) 474-3192 | |
(425) 278-0628 |
Full Name | |
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Type | Facility |
Speciality | Clinic/center - Physical Therapy |
Location | 7215 116th Ave Se, Newcastle, Washington |
Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1952961419 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
225100000X | Physical Therapist | (* (Not Available)) | Secondary |
261QP2000X | Clinic/center - Physical Therapy | (* (Not Available)) | Primary |
Provider Name | Kathleen Koenig |
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Provider Type | Practitioner - Physical Therapist In Private Practice |
Provider Identifiers | NPI Number: 1992844534 PECOS PAC ID: 5597062851 Enrollment ID: I20160331001233 |
Mailing Address | Practice Location Address |
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7215 116th Ave Se, Newcastle, WA 98056-1102 Ph: (360) 474-3192 | 7215 116th Ave Se, Newcastle, WA 98056-1102 Ph: (360) 474-3192 |