Provider Demographics
NPI:1598450025
Name:DIGE, KAITLYN (PHYSICAL THERAPIST)
Entity Type:Individual
Prefix:
First Name:KAITLYN
Middle Name:
Last Name:DIGE
Suffix:
Gender:F
Credentials:PHYSICAL THERAPIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24060 SE KENT KANGLEY RD STE D100
Mailing Address - Street 2:
Mailing Address - City:MAPLE VALLEY
Mailing Address - State:WA
Mailing Address - Zip Code:98038-6851
Mailing Address - Country:US
Mailing Address - Phone:360-825-7411
Mailing Address - Fax:360-825-7434
Practice Address - Street 1:1040 STEVENSON AVE STE A
Practice Address - Street 2:
Practice Address - City:ENUMCLAW
Practice Address - State:WA
Practice Address - Zip Code:98022-2991
Practice Address - Country:US
Practice Address - Phone:360-825-7411
Practice Address - Fax:360-825-7434
Is Sole Proprietor?:No
Enumeration Date:2023-04-10
Last Update Date:2023-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPT60972848225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist