Provider Demographics
NPI:1043098072
Name:RUNGE, KAARI LEE TAYLOR (PT)
Entity Type:Individual
Prefix:
First Name:KAARI
Middle Name:LEE TAYLOR
Last Name:RUNGE
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4255 SW 338TH ST
Mailing Address - Street 2:
Mailing Address - City:FEDERAL WAY
Mailing Address - State:WA
Mailing Address - Zip Code:98023-3209
Mailing Address - Country:US
Mailing Address - Phone:253-653-3912
Mailing Address - Fax:
Practice Address - Street 1:1407 E 72ND ST STE A100
Practice Address - Street 2:
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98404-5906
Practice Address - Country:US
Practice Address - Phone:253-474-7474
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-09-20
Last Update Date:2023-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA00003861225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist