Kevin Pharis Bohn
Individual provider Active NPI Physical Therapist · Camas, WA
NPI 1902400740 · NPPES record last updated Mar 20, 2024
Key facts
- NPI
- 1902400740
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapist 225100000X
- License
- 15214-24 (WI)
- Practice address
- 1905 SE 192ND Ave Ste 109
Camas, WA 98607-7415 - Phone
- (360) 210-5440
- NPI assigned
- Nov 23, 2020
- Sex
- Male
- Sole proprietor
- No
Medicare Care Compare profile
- Specialty
- Physical Therapist in Private Practice
- Education
- Other, 2020
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
1905 SE 192ND Ave
Suite 109
Camas, WA 98607-7415
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 15214-24 | WI | MD | Physical Therapist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 15214-24 | WI | Yes |
Addresses
Primary practice location
1905 SE 192ND Ave Ste 109
Camas, WA 98607-7415
Mailing address
1905 SE 192ND Ave Ste 109
Camas, WA 98607-7415
Phone (360) 210-5440
Other providers in Camas, WA
- Bianca Blanco
- Maria N Bloomfield
- Blossom Natural Health and Wellness
- Bluestream Counseling LLC
- Body Balance Health and Aesthetics Medicine
- Mark A Bollinger
- Olga Boltenkov
- Brittany Nicole Bonner-Dillon
- Chelsea Easton Brandenburg
- Richard Paul Braskett
All providers in Camas, 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 Mar 20, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.