Provider Demographics
NPI:1023025962
Name:WORDEN, KATHERINE EWING (MPT)
Entity Type:Individual
Prefix:
First Name:KATHERINE
Middle Name:EWING
Last Name:WORDEN
Suffix:
Gender:F
Credentials:MPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5920 S ESTES ST
Mailing Address - Street 2:STE 100
Mailing Address - City:LITTLETON
Mailing Address - State:CO
Mailing Address - Zip Code:80123-8618
Mailing Address - Country:US
Mailing Address - Phone:303-932-2500
Mailing Address - Fax:303-932-2600
Practice Address - Street 1:5920 S ESTES ST
Practice Address - Street 2:STE 100
Practice Address - City:LITTLETON
Practice Address - State:CO
Practice Address - Zip Code:80123-8618
Practice Address - Country:US
Practice Address - Phone:303-932-2500
Practice Address - Fax:303-932-2600
Is Sole Proprietor?:No
Enumeration Date:2006-08-02
Last Update Date:2009-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO7669225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
102255326OtherOWCP PROVIDER ID
CO066600Medicare UPIN