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Individual

KRISTA MARIE ERNSDORF

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
P.T.

Contact information

Practice address
1700 BROADWAY ST, SUITE 101, VANCOUVER, WA 98663-3455
(360) 737-3346
Mailing address
1700 BROADWAY ST, SUITE 101, VANCOUVER, WA 98663-3455
(360) 737-3346

Taxonomy

Speciality
Code
Description
License number
State
2251X0800X
Orthopedic Physical Therapist
Primary
60201103
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0239973
WASHINGTON L & I
OR
05
500606411
OR
01
P00802452
RR MEDICARE
OR
Enumeration date
09/15/2008
Last updated
01/05/2017
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