Provider Demographics
NPI:1407294960
Name:SCOTT, KELSEY ARIEL DEHMER (DPT)
Entity Type:Individual
Prefix:
First Name:KELSEY
Middle Name:ARIEL DEHMER
Last Name:SCOTT
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 1:8750 GREENWOOD AVE N, S-1
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98103
Mailing Address - Country:US
Mailing Address - Phone:206-782-5789
Mailing Address - Fax:206-782-5794
Practice Address - Street 1:3225 NE 125TH ST
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98125-4516
Practice Address - Country:US
Practice Address - Phone:206-736-5880
Practice Address - Fax:206-782-5794
Is Sole Proprietor?:No
Enumeration Date:2013-06-06
Last Update Date:2023-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPT60356438225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA2027841Medicaid
WAG8938471Medicare PIN