Provider Demographics
NPI:1467635813
Name:JANKE, KATHLEEN ELISABETH
Entity Type:Individual
Prefix:
First Name:KATHLEEN
Middle Name:ELISABETH
Last Name:JANKE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:KATHLEEN
Other - Middle Name:ELISABETH
Other - Last Name:POLAND
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:222 E 5TH AVE
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99202-1394
Mailing Address - Country:US
Mailing Address - Phone:509-344-5084
Mailing Address - Fax:
Practice Address - Street 1:222 E 5TH AVE
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99202-1394
Practice Address - Country:US
Practice Address - Phone:509-344-5084
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-12-07
Last Update Date:2007-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant