Provider Demographics
NPI:1205218484
Name:SCHLECHT, KEITH PATRICK (DPT, ATC)
Entity Type:Individual
Prefix:
First Name:KEITH
Middle Name:PATRICK
Last Name:SCHLECHT
Suffix:
Gender:M
Credentials:DPT, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12121 HARBOUR REACH DR STE 100
Mailing Address - Street 2:
Mailing Address - City:MUKILTEO
Mailing Address - State:WA
Mailing Address - Zip Code:98275-5314
Mailing Address - Country:US
Mailing Address - Phone:425-493-8313
Mailing Address - Fax:
Practice Address - Street 1:12121 HARBOUR REACH DR STE 100
Practice Address - Street 2:
Practice Address - City:MUKILTEO
Practice Address - State:WA
Practice Address - Zip Code:98275-5314
Practice Address - Country:US
Practice Address - Phone:425-493-8313
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-06-23
Last Update Date:2015-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPT60554006225100000X
WAA1601800402255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer