Provider Demographics
NPI:1164831855
Name:DUIMSTRA, MAREN (PT, DPT)
Entity Type:Individual
Prefix:
First Name:MAREN
Middle Name:
Last Name:DUIMSTRA
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:MAREN
Other - Middle Name:KAY
Other - Last Name:KLUDT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT, DPT
Mailing Address - Street 1:11800 NE 128TH ST STE 510
Mailing Address - Street 2:
Mailing Address - City:KIRKLAND
Mailing Address - State:WA
Mailing Address - Zip Code:98034-7296
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:11800 NE 128TH ST STE 510
Practice Address - Street 2:
Practice Address - City:KIRKLAND
Practice Address - State:WA
Practice Address - Zip Code:98034-7296
Practice Address - Country:US
Practice Address - Phone:425-820-2590
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-08-06
Last Update Date:2023-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA604833432251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic