Individual
LAURA LYNN KETTEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DPT
Contact information
Practice address
34617 11TH PL S STE 201, FEDERAL WAY, WA 98003-8706
(253) 815-1117
(253) 815-1107
Mailing address
4040 ORCHARD ST W STE 100, FIRCREST, WA 98466-6610
(951) 696-9353
(951) 973-7216
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PT60754995
PT LICENSURE
WA
Enumeration date
09/13/2017
Last updated
06/16/2018
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