Provider Demographics
NPI:1134476575
Name:SCHNELL, KENNETH EUGENE (PT)
Entity Type:Individual
Prefix:
First Name:KENNETH
Middle Name:EUGENE
Last Name:SCHNELL
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:410 PROVIDENCE LN NE
Mailing Address - Street 2:
Mailing Address - City:OLYMPIA
Mailing Address - State:WA
Mailing Address - Zip Code:98506-6927
Mailing Address - Country:US
Mailing Address - Phone:360-493-4159
Mailing Address - Fax:
Practice Address - Street 1:410 PROVIDENCE LN NE
Practice Address - Street 2:
Practice Address - City:OLYMPIA
Practice Address - State:WA
Practice Address - Zip Code:98506-6927
Practice Address - Country:US
Practice Address - Phone:360-493-4159
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-08-03
Last Update Date:2012-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA601816852251N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251N0400XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistNeurology