Provider Demographics
NPI:1215205117
Name:WALTERS, KELSEY KAREN (DPT)
Entity Type:Individual
Prefix:MISS
First Name:KELSEY
Middle Name:KAREN
Last Name:WALTERS
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8495 161ST AVE NE
Mailing Address - Street 2:
Mailing Address - City:REDMOND
Mailing Address - State:WA
Mailing Address - Zip Code:98052-3849
Mailing Address - Country:US
Mailing Address - Phone:425-881-3001
Mailing Address - Fax:425-881-3585
Practice Address - Street 1:8495 161ST AVE NE
Practice Address - Street 2:
Practice Address - City:REDMOND
Practice Address - State:WA
Practice Address - Zip Code:98052-3849
Practice Address - Country:US
Practice Address - Phone:425-881-3001
Practice Address - Fax:425-881-3585
Is Sole Proprietor?:No
Enumeration Date:2011-12-06
Last Update Date:2011-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA60246342225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist