Katelyn Frentress, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

61071975 Issued in WA

Practice address

900 NE 139TH St Ste 102
Vancouver, WA 98685-2519

Phone

(360) 573-3611

NPI assigned

Jun 2, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Dr. Katelyn Phan Former name

Medicare fee-for-service enrollment

Enrolled in WA, OR2 enrollments

Enrollment records 2

Specialty

Physical Therapist in Private Practice

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Peak Motion PLLCGroup PAC ID 6103071014, 30 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Peak Motion, PLLC

  • Physical Therapy Clinic/Center
  • Camas, WA
  • NPI 1588916894

  OR, Physical Therapist

  Medicare reassignment Care Compare group NPD
• Peacehealth

  • Prosthetic/Orthotic Supplier
  • Longview, WA
  • NPI 1184106437
  NPD (past)

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

{
    "created_epoch": "1591056000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710892800000",
    "number": "1104440494",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9009 NE 163RD AVE",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986820730",
            "telephone_number": "650-279-4102"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 NE 139TH ST STE 102",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986852519",
            "telephone_number": "360-573-3611"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1905 SE 192nd Ave Ste 109",
            "address_purpose": "LOCATION",
            "city": "Camas",
            "state": "WA",
            "postal_code": "986077415",
            "country_code": "US",
            "telephone_number": "360-210-5440",
            "fax_number": "360-210-7731",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FRENTRESS",
        "first_name": "KATELYN",
        "name_prefix": "Dr.",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-06-02",
        "last_updated": "2024-03-20",
        "certification_date": "2024-03-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WA",
            "license": "61071975",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2158301",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KATELYN",
            "last_name": "PHAN",
            "prefix": "DR.",
            "credential": "DPT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Scott Freeman, D.C.
• Yvonne Frei, M.D.
• Naomi Frein
• Matthew French Wallace, PA-C
• Kaia Butzman French, DPT
• Fresh Horizons Massage LLC
• Jennifer Fresh, PMHNP, ARNP
• Jon Frew, PH.D
• Patricia Marie Frew, MD
• Blake Gregory Frey, MA

• Physical Therapist in Vancouver, WA
• Providers in Vancouver, WA by specialty
• Physical Therapist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.