Provider Demographics
NPI:1407932957
Name:KRINGS, MATT T (MPT)
Entity Type:Individual
Prefix:
First Name:MATT
Middle Name:T
Last Name:KRINGS
Suffix:
Gender:M
Credentials:MPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:790 REMINGTON BLVD
Mailing Address - Street 2:
Mailing Address - City:BOLINGBROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60440-4909
Mailing Address - Country:US
Mailing Address - Phone:630-296-2223
Mailing Address - Fax:630-759-9510
Practice Address - Street 1:6601 220TH ST SW
Practice Address - Street 2:SUITE 1
Practice Address - City:MOUNTLAKE TERRACE
Practice Address - State:WA
Practice Address - Zip Code:98043-2166
Practice Address - Country:US
Practice Address - Phone:425-775-7274
Practice Address - Fax:425-775-0963
Is Sole Proprietor?:No
Enumeration Date:2006-10-27
Last Update Date:2015-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPT00009079225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA169252OtherDEPT OF LABOR & INDUSTRY
WAA022OtherTRICARE
WAP00004293OtherRAILROAD MEDICARE
WA0290917OtherDEPT. OF LABOR AND INDUSTRIES
WA6854KROtherREGENCE BLUE SHIELD
WA8337149Medicaid
WA8934688OtherCRIME VICTIMS
WA0290917OtherDEPT. OF LABOR AND INDUSTRIES
WA6854KROtherREGENCE BLUE SHIELD
WAP00004293OtherRAILROAD MEDICARE