Daniel William Kalani Kruse, PTA

Primary specialty

Pediatric Rehabilitation Medicine PhysicianTaxonomy code 2081P0010X

License

P160439817 Issued in WA

Practice address

6912 220TH St SW
200
Mountlake Terrace, WA 98043-2169

Phone

(425) 672-2716

Fax

(425) 672-2720

NPI assigned

Oct 10, 2014

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Rescare Rehab Without Walls Outpatient Center

  • Rehabilitation Clinic/Center
  • Mountlake Terrace, WA
  • NPI 1063827772
  NPD (past)

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

{
    "created_epoch": "1412899200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1412899200000",
    "number": "1750785317",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22503 62ND AVE W",
            "city": "MOUNTLAKE TERRACE",
            "state": "WA",
            "postal_code": "980432507",
            "telephone_number": "425-877-0869"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6912 220TH ST SW",
            "address_2": "200",
            "city": "MOUNTLAKE TERRACE",
            "state": "WA",
            "postal_code": "980432169",
            "telephone_number": "425-672-2716",
            "fax_number": "425-672-2720"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KRUSE",
        "first_name": "DANIEL",
        "middle_name": "WILLIAM KALANI",
        "credential": "PTA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-10-10",
        "last_updated": "2014-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2081P0010X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation, Pediatric Rehabilitation Medicine",
            "state": "WA",
            "license": "P160439817",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Vuk Kovacevic, PHARMD
• Victoria Kraft, ATC
• Matt T Krings, MPT
• Kathryn Marie Kritta, ATC
• Virginia Ruth Krochmalny
• Alanna Megan Kudeviz
• Mirsada Kulovac
• Roomi Kunuria, MED
• Elaine Kuo
• Monica Labrie, BCBA, LBA

• Pediatric Rehabilitation Medicine Physician in Mountlake Terrace, WA
• Providers in Mountlake Terrace, WA by specialty
• Pediatric Rehabilitation Medicine Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2014; 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.