Provider Demographics
NPI:1235342254
Name:KUNKLE, BABBETTE MAE (PTA)
Entity Type:Individual
Prefix:MS
First Name:BABBETTE
Middle Name:MAE
Last Name:KUNKLE
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11714 101ST AVE E
Mailing Address - Street 2:
Mailing Address - City:PUYALLUP
Mailing Address - State:WA
Mailing Address - Zip Code:98373-3677
Mailing Address - Country:US
Mailing Address - Phone:253-845-8071
Mailing Address - Fax:
Practice Address - Street 1:1010 S. 336TH ST.
Practice Address - Street 2:SUITE 120
Practice Address - City:FEDERAL WAY
Practice Address - State:WA
Practice Address - Zip Code:98003
Practice Address - Country:US
Practice Address - Phone:866-835-8091
Practice Address - Fax:866-835-7102
Is Sole Proprietor?:No
Enumeration Date:2007-05-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant