Provider Demographics
NPI:1235253048
Name:FRANZEN, KEITH A (MA, PT)
Entity Type:Individual
Prefix:
First Name:KEITH
Middle Name:A
Last Name:FRANZEN
Suffix:
Gender:M
Credentials:MA, PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2203 INGLEWOOD
Mailing Address - Street 2:
Mailing Address - City:EAST WENATCHEE
Mailing Address - State:WA
Mailing Address - Zip Code:98802
Mailing Address - Country:US
Mailing Address - Phone:509-293-4328
Mailing Address - Fax:
Practice Address - Street 1:230 GRANT ROAD, SUITE B27
Practice Address - Street 2:
Practice Address - City:EAST WENATCHEE
Practice Address - State:WA
Practice Address - Zip Code:98802
Practice Address - Country:US
Practice Address - Phone:509-884-1437
Practice Address - Fax:509-884-2811
Is Sole Proprietor?:No
Enumeration Date:2007-03-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPT00005895225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA7052665Medicaid
WA8857725Medicare ID - Type Unspecified