Individual
KATHRYN FONTANA DALE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT, OCS
Contact information
Practice address
451 SW SEDGWICK RD, STE. 310, PORT ORCHARD, WA 98367-6447
(360) 874-8009
(360) 874-8010
Mailing address
4040 ORCHARD ST W, STE. 100, FIRCREST, WA 98466-6606
(253) 564-1560
(253) 564-4449
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT00003228
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
216083
L&I
WA
05
—
8341794
—
WA
Enumeration date
12/14/2006
Last updated
03/10/2014
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