Individual provider Active NPI

Katelyn Rose Hrehov, PTA

  • Physical Therapy Assistant
  • Renton, WA
National Provider Identifier
1174266084
Registry record updated Apr 18, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
P160865177 Issued in WA
Practice address
104 Burnett Ave S
Renton, WA 98057-2121
Phone
(425) 271-1911
NPI assigned
Apr 18, 2022
Last updated
Apr 18, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 18, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X P160865177 WA Primary

Addresses

Primary practice location

104 Burnett Ave S
Renton, WA 98057-2121

Mailing address

22003 39TH PL S
Kent, WA 98032-8429
Phone (206) 948-8602

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
P160865177WAMDPhysical Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1650240000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1650240000000",
    "number": "1174266084",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22003 39TH PL S",
            "city": "KENT",
            "state": "WA",
            "postal_code": "980328429",
            "telephone_number": "206-948-8602"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "104 BURNETT AVE S",
            "city": "RENTON",
            "state": "WA",
            "postal_code": "980572121",
            "telephone_number": "425-271-1911"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HREHOV",
        "first_name": "KATELYN",
        "middle_name": "ROSE",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-04-18",
        "last_updated": "2022-04-18",
        "certification_date": "2022-04-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "WA",
            "license": "P160865177",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Renton, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 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.