Individual
CARISSA RENEE KONO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
21601 76TH AVE W, EDMONDS, WA 98026-7507
(425) 640-4145
Mailing address
1131 SEA VISTA PL, EDMONDS, WA 98020-4653
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT61325380
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PT61325380
PHYSICAL THERAPY CREDENTIAL NUMBER
WA
Enumeration date
08/05/2022
Last updated
08/05/2022
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