Kyle William Wisniewski, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

61205687 Issued in WA

Practice address

1227 N 205TH St
Shoreline, WA 98133-3214

Phone

(206) 546-2220

NPI assigned

Feb 23, 2022

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1645574400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1645574400000",
    "number": "1013663566",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11716 GREENWOOD AVE N APT 301",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981338162",
            "telephone_number": "206-349-3827"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1227 N 205TH ST",
            "city": "SHORELINE",
            "state": "WA",
            "postal_code": "981333214",
            "telephone_number": "206-546-2220"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WISNIEWSKI",
        "first_name": "KYLE",
        "middle_name": "WILLIAM",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-02-23",
        "last_updated": "2022-02-23",
        "certification_date": "2022-02-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "WA",
            "license": "61205687",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Zan Williams, PT
• Jacqueline M Wilson, RN
• Lisa Winchell, ARNP, DNP
• Jonathan Winship
• Deborah Christina Winston, CDPT
• Mary Jane Witmer
• Christopher A Wodja, DMD
• Yosef Hailu Woger, PHARMD
• Katieann Wohlford
• Senayet Mary Woldemariam, D.P.T.

• Physical Therapy Assistant in Shoreline, WA
• Providers in Shoreline, WA by specialty
• Physical Therapy Assistant in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.