Kelsi Antonsen Chang, DPT
Individual provider Active NPI Physical Therapist · Graham, WA
NPI 1235844341 · NPPES record last updated Nov 22, 2023
Key facts
- NPI
- 1235844341
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapist 225100000X
- License
- 61384435 (WA)
- Practice address
- 9909 224TH St E Unit 100B
Graham, WA 98338-7086 - Phone
- (253) 780-4968
- NPI assigned
- Jan 23, 2023
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
Medicare Care Compare profile
- Specialty
- Physical Therapist in Private Practice
- Education
- Other, 2022
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Ross M. Anderson, Anchor Physical Therapy
Practice addresses (Care Compare)
1407 E 72ND St
Suite A100
Tacoma, WA 98404-5906
Phone (253) 474-7474
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in WA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20231002003186 | WA | Practitioner - Physical Therapist in Private Practice | 3971957424 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 61384435 | WA | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Ross M. Anderson, Anchor Physical Therapy | Physical Therapist | Current |
Accepting new patients |
| Therapydia of Washington PC | Physical Therapist | Past |
Accepting new patients |
Locations
6030 Main St SW
Ste D
Lakewood, WA 98499
Phone (253) 347-4747
1407 E 72nd St
Ste A100
Tacoma, WA 98404
Phone (253) 474-7474
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 61384435 | WA | Yes |
Addresses
Primary practice location
9909 224TH St E Unit 100B
Graham, WA 98338-7086
Mailing address
13506 62ND Ave E
Puyallup, WA 98373-5166
Other providers in Graham, WA
- Sara Michele Allen
- Alliance Physical Therapy
- Karen Marie Anderson
- Tamara L Anderson
- Angela Erdahl, RN
- Apple Physical Therapy LLC
- Apple Physical Therapy, LLC
- Ascend Family Chiropractic LLC
- Kaitlyn Aus
- Avian Adult Family Home H LLC
All providers in Graham, WA · Physical Therapist in Washington
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 22, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.