Individual
MR. KEVIN P GRAHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
9514 4TH ST NE, SUITE 101, LAKE STEVENS, WA 98258-1937
(425) 397-2327
(425) 377-0283
Mailing address
10505 19TH AVE SE, SUITE B, EVERETT, WA 98208-4280
(408) 570-0510
(408) 945-4018
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT00003966
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8340184
—
WA
Enumeration date
02/09/2007
Last updated
03/13/2013
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