Kenny Chan
Individual provider Active NPI Physical Therapy Assistant · Newcastle, WA
NPI 1497468607 · NPPES record last updated Jan 3, 2023
Key facts
- NPI
- 1497468607
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapy Assistant 225200000X
- License
- P1-60067333 (WA)
- Practice address
- 13056 SE 76TH St
Newcastle, WA 98056-4159 - Phone
- (425) 386-3833
- NPI assigned
- Jan 3, 2023
- Sex
- Male
- 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
| License | State | Type | Specialty |
|---|---|---|---|
| P1-60067333 | WA | MD | Physical Therapy Assistant |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapy Assistant | 225200000X | P1-60067333 | WA | Yes |
Addresses
Primary practice location
13056 SE 76TH St
Newcastle, WA 98056-4159
Mailing address
12834 SE 41St LN Unit E101
Bellevue, WA 98006-1210
Phone (206) 214-6388
Other providers in Newcastle, WA
- David Campnell
- Sharon Lee Carleton
- Kristin Winn Carter
- Cascade Healthcare Solutions LLC
- Juanita Cazares
- Ethan Chang
- Heather D Chibambo
- China Creek VI, LLC
- Chiropractic Wellness Centers PS Inc
- Peter C Chiu
All providers in Newcastle, WA · Physical Therapy Assistant in Washington
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 3, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.