Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251P0200X | Physical Therapist - Pediatrics | 00005389 | WA |
NPI | 1013332899 |
---|---|
Provider Name | Ms. Kathryn Mary Kraynak |
First Address | Bellingham, WA 98225-7824 |
Second Address | Ferndale, WA 98248-9317 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 03/03/2014 |
Last Update Date | 03/03/2014 |