Kris Allen, PTA

Key facts

NPI

1306399050

Entity type

Individual (NPI type 1)

Primary specialty

Physical Therapy Assistant 225200000X

License

P160046073 (WA)

Practice address

1620 SE Summit CT
Pullman, WA 99163-5540

Phone

(509) 332-5106

Fax

(509) 334-5723

NPI assigned

Jul 29, 2016

Sex

Female

Sole proprietor

No

Medicare participation

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)

No

State licenses

Specialties & licenses

Addresses

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Jul 29, 2016.

{
    "created_epoch": "1469750400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1469750400000",
    "number": "1306399050",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1620 SE SUMMIT CT",
            "city": "PULLMAN",
            "state": "WA",
            "postal_code": "991635540",
            "telephone_number": "509-332-5106",
            "fax_number": "509-334-5723"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1620 SE SUMMIT CT",
            "city": "PULLMAN",
            "state": "WA",
            "postal_code": "991635540",
            "telephone_number": "509-332-5106",
            "fax_number": "509-334-5723"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALLEN",
        "first_name": "KRIS",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-07-29",
        "last_updated": "2016-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "WA",
            "license": "P160046073",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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All providers in Pullman, WA · Physical Therapy Assistant in Washington