Provider Demographics
NPI:1578939294
Name:HARRELL, KARLIE MICHELLE (PT, DPT)
Entity Type:Individual
Prefix:DR
First Name:KARLIE
Middle Name:MICHELLE
Last Name:HARRELL
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7320 216TH ST SW STE 320
Mailing Address - Street 2:
Mailing Address - City:EDMONDS
Mailing Address - State:WA
Mailing Address - Zip Code:98026-8006
Mailing Address - Country:US
Mailing Address - Phone:425-673-3900
Mailing Address - Fax:425-673-3910
Practice Address - Street 1:7320 216TH ST SW STE 320
Practice Address - Street 2:
Practice Address - City:EDMONDS
Practice Address - State:WA
Practice Address - Zip Code:98026-8006
Practice Address - Country:US
Practice Address - Phone:425-673-3916
Practice Address - Fax:425-673-3926
Is Sole Proprietor?:No
Enumeration Date:2015-08-17
Last Update Date:2024-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1265553225100000X
WAPT61093419225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1265553OtherTEXAS BOARD OF PHYSICAL THERAPY EXAMINERS