Kingsford Physical Therapy and Wellness PLLC

Primary specialty

Physical Therapy Clinic/CenterTaxonomy code 261QP2000X

Legal business name

KINGSFORD PHYSICAL THERAPY AND WELLNESS PLLC

Practice address

2207 N Molter Rd Ste 203
Liberty Lake, WA 99019-7571

Phone

(509) 598-9402

Fax

(509) 436-1139

NPI assigned

Aug 10, 2020

Organization subpart

No

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

Authorized official

Name

Braiden Kingsford, DPTNPI 1376096875

Title

Owner/Provider

Phone

(509) 598-9402

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in ID, WA2 enrollments

Enrollment records 2

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Braiden Kingsford, DPT

  • Physical Therapist
  • Liberty Lake, WA
  • NPI 1376096875

  ID

  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1597017600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1692230400000",
    "number": "1821609249",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 72",
            "city": "LIBERTY LAKE",
            "state": "WA",
            "postal_code": "990190072",
            "telephone_number": "509-598-9402"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2207 N MOLTER RD STE 203",
            "city": "LIBERTY LAKE",
            "state": "WA",
            "postal_code": "990197571",
            "telephone_number": "509-598-9402",
            "fax_number": "509-436-1139"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KINGSFORD PHYSICAL THERAPY AND WELLNESS PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-08-10",
        "last_updated": "2023-08-17",
        "certification_date": "2023-08-17",
        "status": "A",
        "authorized_official_last_name": "KINGSFORD",
        "authorized_official_first_name": "BRAIDEN",
        "authorized_official_title_or_position": "OWNER/PROVIDER",
        "authorized_official_telephone_number": "509-598-9402",
        "authorized_official_credential": "DPT"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Karey Kananda, APRN
• Lisa June Kangas, OTR
• Keenan Milonas M.D. Professional Services PLLC
• Criswell Allen Kennedy, M.D.
• Kinetic Chiropractic LLC
• Braiden Kingsford, DPT
• Leaann P Kinney, PHARMD
• Kenzi Kuemper
• Marian J Kuhlman, L.M.T.
• Mary E Kulisch, LMT

• Physical Therapy Clinic/Center in Liberty Lake, WA
• Providers in Liberty Lake, WA by specialty
• Physical Therapy Clinic/Center in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.