Individual
KATHRYN WIEDEMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPTA
Contact information
Practice address
801 SE PARK CRESTT AVE, VANCOUVER, WA 98683
(360) 260-2200
Mailing address
801 SE PARK CREST AVE, VANCOUVER, WA 98683-1300
(360) 260-2200
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
P1 60040952
WA
225200000X
Physical Therapy Assistant
P160040952
WA
Other
Enumeration date
02/05/2015
Last updated
02/05/2015
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