Individual provider Active NPI

Kenneth Graber, DPT

  • Physical Therapist
  • Bellingham, WA
National Provider Identifier
1538641386
Registry record updated Oct 19, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
60867474 Issued in WA
Practice address
2075 Barkley Blvd Ste 200
Bellingham, WA 98226-6696
Phone
(360) 733-4008
Fax
(360) 733-4064
NPI assigned
Aug 29, 2018
Last updated
Oct 19, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 19, 2025

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 60867474 WA Primary

Addresses

Primary practice location

2075 Barkley Blvd Ste 200
Bellingham, WA 98226-6696

Mailing address

805 Madison St Ste 901
Seattle, WA 98104-1172
Phone (360) 733-4008

Other identifiers 1

IdentifierTypeStateIssuer
2106790MedicaidWA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20181010003606 WA Practitioner - Physical Therapist in Private Practice 0749532224 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Proliance Surgeons Inc P SGroup PAC ID 8527972900, 395 clinicians
Javaman PSGroup PAC ID 1456265263, 15 clinicians

Practice addresses (Care Compare)

1401 S Laventure Rd
Mount Vernon, WA 98274-6033
Phone (360) 424-2400

2075 Barkley Blvd
Suite 200
Bellingham, WA 98226-6696
Phone (360) 733-4008

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
60867474WAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Proliance Surgeons Inc P S Current Accepting new patients
Proliance Surgeons Inc P S CurrentSince Oct 1, 2025 Accepting new patients
Apple Physical Therapy LLC Physical Therapist CurrentSince Aug 27, 2018 Accepting new patients
Javaman PS Physical Therapist CurrentSince Oct 3, 2018 Accepting new patients
Apple Physical Therapy, LLC Physical Therapist CurrentSince Aug 27, 2018 Accepting new patients
Proliance Surgeons, Inc., P.S. CurrentSince Oct 1, 2025 Accepting new patients
Proliance Surgeons Inc., P.S. Past Accepting new patients

Locations

790 Remington Blvd
Bolingbrook, IL 60440

4947 Paysphere Cir
Chicago, IL 60674
Phone (630) 783-2001

2075 Barkley Blvd
Ste 200
Bellingham, WA 98226
Phone (360) 733-4008

4220 Hoyt Ave
Everett, WA 98203
Phone (425) 258-5330

32030 23rd Ave S
Federal Way, WA 98003
Phone (253) 946-4852

130 Marvin Rd SE
Ste 203
Lacey, WA 98503
Phone (360) 456-3300

1401 S Laventure Rd
Mount Vernon, WA 98274
Phone (360) 424-2400

17650 140th Ave SE
Ste B7
Renton, WA 98058
Phone (425) 430-0700

805 Madison St
Ste 901
Seattle, WA 98104
Phone (206) 264-8100

Interoperability endpoints

  • Direct secure messaging: kenneth.graber.p13@direct.proliance.nextgenshare.com

Organizations & group practices 7

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1535500800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1760832000000",
    "number": "1538641386",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "805 MADISON ST STE 901",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981041172",
            "telephone_number": "360-733-4008",
            "fax_number": "360-733-4064"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2075 BARKLEY BLVD STE 200",
            "city": "BELLINGHAM",
            "state": "WA",
            "postal_code": "982266696",
            "telephone_number": "360-733-4008",
            "fax_number": "360-733-4064"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRABER",
        "first_name": "KENNETH",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-08-29",
        "last_updated": "2025-10-19",
        "certification_date": "2025-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WA",
            "license": "60867474",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2106790",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bellingham, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.