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Individual

MR. CODY THOMAS KENISON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.P.T.

Contact information

Practice address
201 W NORTH RIVER DR, SUITE 510, SPOKANE, WA 99201-2284
(509) 323-0066
(509) 323-0067
Mailing address
4220 132ND ST SE, SUITE101, MILL CREEK, WA 98012-8999
(425) 357-9380
(425) 357-9382

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT60099101
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0001KE
REGENCE
WA
01
0002KE
REGENCE
WA
01
0003KE
REGENCE
WA
01
0004KE
REGENCE
WA
01
0005KE
REGENCE
WA
01
0006KE
REGENCE
WA
01
0007KE
REGENCE
WA
01
0008KE
REGENCE
WA
01
0052KE
REGENCE
WA
01
0091KE
REGENCE
WA
01
0253448
L&I
WA
01
0256347
L&I
WA
01
0258152
L&I
WA
01
8599995
DSHS
WA
01
P00907202
MEDICARE RAILROAD
WA
Enumeration date
06/12/2007
Last updated
05/01/2017
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