Henricksen Physical Therapy PLLC

Primary specialty

Physical Therapy Clinic/CenterTaxonomy code 261QP2000X

Legal business name

HENRICKSEN PHYSICAL THERAPY PLLC

Practice address

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

Phone

(360) 789-5384

NPI assigned

Mar 12, 2025

Last updated

Apr 28, 2025By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Kelli Henricksen, DPTNPI 1790931616

Title

Owner / Manager /Physical Therapist

Phone

(360) 789-5384

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in WA

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Kelli Ann Henricksen, DPT

  • Physical Therapist
  • Olympia, WA
  • NPI 1790931616
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1741737600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1745798400000",
    "number": "1932908837",
    "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"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HENRICKSEN PHYSICAL THERAPY PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-03-12",
        "last_updated": "2025-04-28",
        "certification_date": "2025-04-28",
        "status": "A",
        "authorized_official_last_name": "HENRICKSEN",
        "authorized_official_first_name": "KELLI",
        "authorized_official_title_or_position": "OWNER / MANAGER /PHYSICAL THERAPIST",
        "authorized_official_telephone_number": "360-789-5384",
        "authorized_official_credential": "DPT"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Grace Elisabeth Hendry
• Julie A Henegan, LCCE
• Richard Norman Henegan, MD
• Margaret Marie Hennessey, FNP
• Holli Henningsen Jerdes
• Kelli Ann Henricksen, DPT
• Stephanie Henriet, MA
• Victoria Rose Henrikson, DNP, FNP-C
• Henry L Degive MD MC PS
• Abril Henry, ARNP

• Physical Therapy Clinic/Center in Olympia, WA
• Providers in Olympia, 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 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.