Individual provider Active NPI

Erin Kimber, PTA

  • Physical Therapy Assistant
  • Mountlake Terrace, WA
National Provider Identifier
1548090921
Registry record updated Aug 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
P161003637 Issued in WA
Practice address
23303 58TH Ave W
Mountlake Terrace, WA 98043-4600
Phone
(907) 317-8024
NPI assigned
Aug 1, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 1, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X P161003637 WA Primary

Addresses

Primary practice location

23303 58TH Ave W
Mountlake Terrace, WA 98043-4600

Mailing address

9400 Ravenna Ave NE Apt 1
Seattle, WA 98115-3363
Phone (907) 317-8024

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

State licenses

LicenseStateTypeSpecialty
P161003637WAMDPhysical Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1722470400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722470400000",
    "number": "1548090921",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9400 RAVENNA AVE NE APT 1",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981153363",
            "telephone_number": "907-317-8024"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23303 58TH AVE W",
            "city": "MOUNTLAKE TERRACE",
            "state": "WA",
            "postal_code": "980434600",
            "telephone_number": "907-317-8024"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIMBER",
        "first_name": "ERIN",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-08-01",
        "last_updated": "2024-08-01",
        "certification_date": "2024-08-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "WA",
            "license": "P161003637",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mountlake Terrace, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 2024; 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.