Individual
KRISTINE MAIA RAE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
1905 PINE ST, SANDPOINT, ID 83864-8311
(208) 263-7998
(208) 255-2423
Mailing address
1905 PINE ST, SANDPOINT, ID 83864-8311
(208) 290-2504
(208) 255-2423
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT-5344
ID
225100000X
Physical Therapist
PT00008363
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PT-5344
PT LICENSE
ID
Enumeration date
02/03/2010
Last updated
07/29/2019
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