Organization
KINETIC PHYSICAL THERAPY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
FAWN JENNIE COUSSENS MSPT (PHYSICAL THERAPIST, OWNER)
(206) 632-0163
Entity
Organization
Contact information
Practice address
4828 CALIFORNIA AVE SW, SEATTLE, WA 98116-4415
(206) 632-0163
(206) 932-2353
Mailing address
4828 CALIFORNIA AVE SW, SEATTLE, WA 98116-4415
(206) 632-0163
(206) 932-2353
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
602928536
WA
261QP2000X
Physical Therapy Clinic/Center
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Other
Enumeration date
05/26/2011
Last updated
08/30/2022
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