Provider Demographics
NPI:1447217278
Name:MAURI, KERRY ASH (PT)
Entity Type:Individual
Prefix:MRS
First Name:KERRY
Middle Name:ASH
Last Name:MAURI
Suffix:
Gender:F
Credentials:PT
Other - Prefix:MRS
Other - First Name:KERRY
Other - Middle Name:LYNNE
Other - Last Name:ASH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:9725 3RD AVE NE
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98115-2060
Mailing Address - Country:US
Mailing Address - Phone:206-706-7500
Mailing Address - Fax:206-706-7890
Practice Address - Street 1:9725 3RD AVE NE
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98115-2060
Practice Address - Country:US
Practice Address - Phone:206-706-7500
Practice Address - Fax:206-706-7890
Is Sole Proprietor?:No
Enumeration Date:2006-04-26
Last Update Date:2015-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPT00009273225100000X
NY022492225100000X
MA15664225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA1447217278Medicaid
WA8377764Medicaid
WA8800250Medicare PIN