Kelli Ann Henricksen, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT60028377 Issued in WA

Practice address

3721 Griffin LN SE Ste 101
Olympia, WA 98501-2192

Phone

(360) 789-5384

Fax

(360) 918-9713

NPI assigned

Aug 12, 2008

Last updated

Apr 28, 2025By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Enrolled in WA

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2008

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Henricksen Physical Therapy PLLC

  • Physical Therapy Clinic/Center
  • Olympia, WA
  • NPI 1932908837
  Medicare reassignment NPD Authorized official
• Olympia Physical Therapy & Industrial Rehabilitation, Inc.

  • Physical Therapist
  • Tumwater, WA
  • NPI 1174562953
  NPD (past)
• Olympia Physical Therapy & Industrial Rehabilitation, Inc.

  • Physical Therapist
  • Lacey, WA
  • NPI 1467632745
  NPD (past)

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

{
    "created_epoch": "1218499200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745798400000",
    "number": "1790931616",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4250 MARTIN WAY E STE 105",
            "address_2": "PMB 236",
            "city": "OLYMPIA",
            "state": "WA",
            "postal_code": "985165317",
            "telephone_number": "360-789-5384",
            "fax_number": "360-918-9713"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3721 GRIFFIN LN SE STE 101",
            "city": "OLYMPIA",
            "state": "WA",
            "postal_code": "985012192",
            "telephone_number": "360-789-5384",
            "fax_number": "360-918-9713"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENRICKSEN",
        "first_name": "KELLI",
        "middle_name": "ANN",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-08-12",
        "last_updated": "2025-04-28",
        "certification_date": "2025-04-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WA",
            "license": "PT60028377",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Julie A Henegan, LCCE
• Richard Norman Henegan, MD
• Margaret Marie Hennessey, FNP
• Holli Henningsen Jerdes
• Henricksen Physical Therapy PLLC
• Stephanie Henriet, MA
• Victoria Rose Henrikson, DNP, FNP-C
• Henry L Degive MD MC PS
• Abril Henry, ARNP
• Margaret Marie Henry, LMP, LPTA

• Physical Therapist in Olympia, WA
• Providers in Olympia, WA by specialty
• Physical Therapist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 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.