Individual
KEZIA G NAILLIEUX-JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
2201 NE 65TH ST, SEATTLE, WA 98115-7020
(206) 535-7356
(206) 466-1527
Mailing address
3603 S MCCLELLAN ST, SEATTLE, WA 98144-5615
(206) 535-7356
(206) 466-1527
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
05010829A
IN
225100000X
Physical Therapist
Primary
PT60585779
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P01490671
RR MEDICARE
IN
Enumeration date
05/11/2012
Last updated
11/29/2021
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