Individual
MS. CAROL J KENNEDY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
937 NW 96TH ST, SEATTLE, WA 98117-2244
(206) 789-6099
(206) 789-3323
Mailing address
937 NW 96TH ST, SEATTLE, WA 98117-2244
(206) 789-6099
(206) 789-3323
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT00003396
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
KE5476
REGENCE INSURANCE
WA
01
—
PT00003396
PT LICENSE #
WA
Enumeration date
02/19/2007
Last updated
07/08/2007
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