Provider Demographics
NPI:1417128919
Name:EASTER, KRISTIN (PT)
Entity Type:Individual
Prefix:
First Name:KRISTIN
Middle Name:
Last Name:EASTER
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3704 142ND PL NE
Mailing Address - Street 2:
Mailing Address - City:BELLEVUE
Mailing Address - State:WA
Mailing Address - Zip Code:98007-3230
Mailing Address - Country:US
Mailing Address - Phone:425-497-8491
Mailing Address - Fax:
Practice Address - Street 1:2445 140TH AVE NE
Practice Address - Street 2:SUITE B105
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98005-1879
Practice Address - Country:US
Practice Address - Phone:425-644-6328
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-03-12
Last Update Date:2008-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPT000091782251P0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics