Provider Demographics
NPI:1558405746
Name:HOLDEN, KRISTOPHER T (MPT)
Entity Type:Individual
Prefix:
First Name:KRISTOPHER
Middle Name:T
Last Name:HOLDEN
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 1:213 S UNIVERSITY RD STE 3
Mailing Address - Street 2:
Mailing Address - City:SPOKANE VALLEY
Mailing Address - State:WA
Mailing Address - Zip Code:99206-5364
Mailing Address - Country:US
Mailing Address - Phone:509-893-0600
Mailing Address - Fax:509-926-5828
Practice Address - Street 1:213 S UNIVERSITY RD STE 3
Practice Address - Street 2:
Practice Address - City:SPOKANE VALLEY
Practice Address - State:WA
Practice Address - Zip Code:99206-5364
Practice Address - Country:US
Practice Address - Phone:509-893-0600
Practice Address - Fax:509-926-5828
Is Sole Proprietor?:No
Enumeration Date:2007-02-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPT00009065225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA8858666Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER