Katie Nicole Huibregtse, DPT
Individual provider Active NPI Physical Therapist · Selah, WA
NPI 1821385154 · NPPES record last updated Oct 31, 2011
Key facts
- NPI
- 1821385154
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapist 225100000X
- License
- PT30212286 (WA)
- Practice address
- 117 S 2ND St
Selah, WA 98942-1307 - Phone
- (509) 697-9109
- Fax
- (509) 697-9122
- NPI assigned
- Jul 7, 2011
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 3
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in WA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20110915000824 | WA | Practitioner - Physical Therapist in Private Practice | 1759552110 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PT30212286 | WA | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Pro-Motion Physical Therapy and Functional Fitness P.C. | Physical Therapist | Current |
Accepting new patients |
| Therapeutic Associates Inc | Physical Therapist | Past | Accepting new patients |
| Therapeutic Associates Inc | Physical Therapist | Past | Accepting new patients |
Locations
2006 W Lincoln Ave
Ste A
Yakima, WA 98902
Phone (509) 573-4816
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | PT30212286 | WA | Yes |
Addresses
Primary practice location
117 S 2ND St
Selah, WA 98942-1307
Mailing address
11481 SW Hall Blvd
Suite 201
Portland, OR 97223-8403
Phone (800) 219-8835
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| P00969335 | Other | WA | RR MEDICARE |
| 1821385154 | Medicaid | WA |
Other providers in Selah, WA
- Magen Maleah Holgate
- Joshua Holliday
- Rhonda S Holt
- Melissa S Hong
- Howards Medical LLC
- Sarah A Hull
- Elliott Hummel
- Baylee Hunt
- Jessie Lynn Ihly
- Margaret M Imrie
All providers in Selah, WA · Physical Therapist in Washington
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 31, 2011. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.