Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225100000X | Physical Therapist | PT60039178 | WA |
NPI | 1003063223 |
---|---|
Provider Name | Lori L. Kirsten |
First Address | Seattle, WA 98144-2712 |
Second Address | Seattle, WA 98144-2712 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/08/2008 |
Last Update Date | 01/03/2021 |