Kathleen Maura Koenig, PT
Individual provider Active NPI Physical Therapist · Newcastle, WA
NPI 1992844534 · NPPES record last updated Jan 31, 2020
Key facts
- NPI
- 1992844534
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapist 225100000X
- License
- 60229092 (WA)
- Practice address
- 7215 116TH Ave SE
Newcastle, WA 98056 - Phone
- (360) 474-3192
- Fax
- (425) 278-0628
- NPI assigned
- Feb 6, 2007
- 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 |
|---|---|---|---|---|
| I20160331001233 | WA | Practitioner - Physical Therapist in Private Practice | 5597062851 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 070010688 | IL | MD | Physical Therapist |
| 60229092 | WA | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Redhead Rehab PLLC | Physical Therapist | Current |
Accepting new patients |
| Apple Physical Therapy, LLC | Physical Therapist | Current |
Accepting new patients |
| Apple Physical Therapy LLC | Physical Therapist | Current |
Accepting new patients |
Locations
790 Remington Blvd
Bolingbrook, IL 60440
4947 Paysphere Cir
Chicago, IL 60674
Phone (630) 783-2001
32030 23rd Ave S
Federal Way, WA 98003
Phone (253) 946-4852
405 NW Gilman Blvd
Ste 200
Issaquah, WA 98027
Phone (425) 392-6804
6985 Coal Creek Pkwy SE
Newcastle, WA 98059
Phone (425) 378-0500
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 070010688 | IL | |
| Physical Therapist | 225100000X | 60229092 | WA | Yes |
Addresses
Primary practice location
7215 116TH Ave SE
Newcastle, WA 98056
Mailing address
7215 116TH Ave SE
Newcastle, WA 98056-1102
Phone (360) 474-3192
Other practice location 1
405 NW Gilman Blvd Suite 200
Issaquah, WA 98027
Phone (425) 392-6804
Other names
- Kathleen Maura Desmond
Other providers in Newcastle, WA
- Shea Judd-Hume
- Kaplan Medical, PLLC
- Joe Kim
- Yoo-Jung Karen Kim
- Courtney King
- Victoria Kolbel
- Krista Kowalchik
- Jessie Nga Kwok Kwan
- Evelyn Faith Lafferty
- Linda Lander
All providers in Newcastle, 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 Jan 31, 2020. 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.