Active NPI
Laura Lynn Kettel, DPT
- Physical Therapist
- Federal Way, WA
National Provider Identifier
1194244889
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- Practice address
- 34617 11TH PL S Ste 201
Federal Way, WA 98003-8706 - Phone
- (253) 815-1117
- Fax
- (253) 815-1107
- NPI assigned
- Sep 13, 2017
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | Primary |
Addresses
Primary practice location
34617 11TH PL S Ste 201
Federal Way, WA 98003-8706
Mailing address
4040 Orchard St W Ste 100
Fircrest, WA 98466-6610
Phone (951) 696-9353
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| PT60754995 | Other | WA | PT LICENSURE |
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)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1505260800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1529107200000",
"number": "1194244889",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4040 ORCHARD ST W STE 100",
"city": "FIRCREST",
"state": "WA",
"postal_code": "984666610",
"telephone_number": "951-696-9353",
"fax_number": "951-973-7216"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "34617 11TH PL S STE 201",
"city": "FEDERAL WAY",
"state": "WA",
"postal_code": "980038706",
"telephone_number": "253-815-1117",
"fax_number": "253-815-1107"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KETTEL",
"first_name": "LAURA",
"middle_name": "LYNN",
"credential": "DPT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-09-13",
"last_updated": "2018-06-16",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PT LICENSURE",
"identifier": "PT60754995",
"state": "WA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Federal Way, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.