Provider Demographics
NPI:1114147519
Name:BROWN, KENDRA MEGHAN (DPT)
Entity Type:Individual
Prefix:
First Name:KENDRA
Middle Name:MEGHAN
Last Name:BROWN
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:KENDRA
Other - Middle Name:MEGHAN
Other - Last Name:LIERE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPT
Mailing Address - Street 1:17618 140TH AVE NE
Mailing Address - Street 2:
Mailing Address - City:WOODINVILLE
Mailing Address - State:WA
Mailing Address - Zip Code:98072-6800
Mailing Address - Country:US
Mailing Address - Phone:425-402-9772
Mailing Address - Fax:425-402-9443
Practice Address - Street 1:17618 140TH AVE NE
Practice Address - Street 2:
Practice Address - City:WOODINVILLE
Practice Address - State:WA
Practice Address - Zip Code:98072-6800
Practice Address - Country:US
Practice Address - Phone:425-402-9772
Practice Address - Fax:425-402-9443
Is Sole Proprietor?:No
Enumeration Date:2007-04-26
Last Update Date:2013-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPT00009181225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist