Individual provider Active NPI

Kyla Ann Damerow, DPT

  • Physical Therapist
  • Renton, WA
National Provider Identifier
1194658922
Registry record updated Aug 4, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT.PT.70113222 Issued in WA
Practice address
405 SW 41St St Ste 407
Renton, WA 98057-4926
Phone
(425) 979-2663
Fax
(425) 656-5047
NPI assigned
Jun 3, 2026
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 4, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT.PT.70113222 WA Primary

Addresses

Primary practice location

405 SW 41St St Ste 407
Renton, WA 98057-4926

Mailing address

4011 Talbot Rd S Ste 300
Renton, WA 98055-5791
Phone (425) 656-5060

Other practice location 1

22443 SE 240th St Ste 201
Maple Valley, WA 98038-5879
Phone (425) 656-5060

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

Practice roles

OrganizationSpecialtyStatusNew patients
Proliance Surgeons Inc P S Physical Therapist Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1780444800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1785801600000",
    "number": "1194658922",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4011 TALBOT RD S STE 300",
            "city": "RENTON",
            "state": "WA",
            "postal_code": "980555791",
            "telephone_number": "425-656-5060",
            "fax_number": "425-656-5047"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "405 SW 41ST ST STE 407",
            "city": "RENTON",
            "state": "WA",
            "postal_code": "980574926",
            "telephone_number": "425-979-2663",
            "fax_number": "425-656-5047"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "22443 SE 240th St Ste 201",
            "address_purpose": "LOCATION",
            "city": "Maple Valley",
            "state": "WA",
            "postal_code": "980385879",
            "country_code": "US",
            "telephone_number": "425-656-5060",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DAMEROW",
        "first_name": "KYLA",
        "middle_name": "ANN",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-06-03",
        "last_updated": "2026-08-04",
        "certification_date": "2026-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WA",
            "license": "PT.PT.70113222",
            "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 Aug 4, 2026; 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.