Kevin Constantin, DPT

Individual provider Active NPI Physical Therapist · Colfax, WA

NPI 1679002893 · NPPES record last updated Jun 9, 2017

Key facts

NPI
1679002893
Entity type
Individual (NPI type 1)
Primary specialty
Physical Therapist 225100000X
License
PT60665011 (WA)
Practice address
1150 W Fairview St
Colfax, WA 99111-9580
Phone
(509) 397-4603
Fax
(509) 397-2441
NPI assigned
Jun 9, 2017
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)
Yes

State licenses

LicenseStateTypeSpecialty
5185IDMDPhysical Therapist
PT60665011WAMDPhysical Therapist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 5185 ID
Physical Therapist 225100000X PT60665011 WA Yes

Addresses

Primary practice location

1150 W Fairview St
Colfax, WA 99111-9580

Mailing address

260 NW Golden Hills Dr SPC 35
Pullman, WA 99163-9767

Other providers in Colfax, WA

All providers in Colfax, WA · Physical Therapist in Washington

Sources for this page

Verify at the official NPI Registry.