Provider Demographics
NPI:1427377258
Name:KILLOREN, PAUL R (DPT)
Entity Type:Individual
Prefix:
First Name:PAUL
Middle Name:R
Last Name:KILLOREN
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:1188 106TH AVE NE
Mailing Address - Street 2:SUITE 100
Mailing Address - City:BELLEVUE
Mailing Address - State:WA
Mailing Address - Zip Code:98004-8614
Mailing Address - Country:US
Mailing Address - Phone:425-454-4864
Mailing Address - Fax:425-646-3901
Practice Address - Street 1:901 BOREN AVE
Practice Address - Street 2:SUITE 410
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98104-3595
Practice Address - Country:US
Practice Address - Phone:206-447-1570
Practice Address - Fax:206-447-1592
Is Sole Proprietor?:No
Enumeration Date:2010-05-18
Last Update Date:2010-12-28
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
WAPT225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAG8896334Medicare PIN