Individual
KERRY O DEGAETANI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
1125 E OLIVE ST STE B, SEATTLE, WA 98122-8406
(206) 972-5978
(206) 322-9169
Mailing address
4701 SW ADMIRAL WAY # 402, SEATTLE, WA 98116-2340
(206) 972-5978
(206) 322-9169
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
—
—
2251X0800X
Orthopedic Physical Therapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
60920912
PT LICENSE
WA
Enumeration date
04/28/2011
Last updated
08/19/2020
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