Provider Demographics
NPI:1598727323
Name:GASSELING, KAY ANN (PT)
Entity Type:Individual
Prefix:
First Name:KAY
Middle Name:ANN
Last Name:GASSELING
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3591 JONES RD
Mailing Address - Street 2:
Mailing Address - City:WAPATO
Mailing Address - State:WA
Mailing Address - Zip Code:98951
Mailing Address - Country:US
Mailing Address - Phone:509-877-2172
Mailing Address - Fax:
Practice Address - Street 1:220 W 1ST AVE
Practice Address - Street 2:
Practice Address - City:TOPPENISH
Practice Address - State:WA
Practice Address - Zip Code:98948-1526
Practice Address - Country:US
Practice Address - Phone:509-865-5650
Practice Address - Fax:509-865-5633
Is Sole Proprietor?:No
Enumeration Date:2006-04-05
Last Update Date:2016-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPT00003566225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA147411OtherL & I
WA8343766Medicaid
WA8343766Medicaid