Individual
CELESTE KYLE INTERRANTE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
2051 POTTERY AVE., PORT ORCHARD, WA 98366
(360) 876-4461
(360) 876-4482
Mailing address
4560 SE INTERNATIONAL WAY, STE. 100, MILWAUKIE, OR 97222
(971) 206-5200
(971) 206-5203
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
P160222785
WA
Other
Enumeration date
08/15/2012
Last updated
08/15/2012
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