Individual
KIMBERLEE JANETTE DESPAIN ELLISON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PT, DPT, C/NDT
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
PT60439302
WA
2251P0200X
Pediatric Physical Therapist
Primary
LPT-30638
AZ
2251P0200X
Pediatric Physical Therapist
PT60439302
WA
Other
Enumeration date
09/28/2014
Last updated
04/29/2019
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