Provider Demographics
NPI:1609362664
Name:ISEMAN, KATRINA RENEE (DPT)
Entity Type:Individual
Prefix:MRS
First Name:KATRINA
Middle Name:RENEE
Last Name:ISEMAN
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:MISS
Other - First Name:KATRINA
Other - Middle Name:RENEE
Other - Last Name:PILCH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPT
Mailing Address - Street 1:11201 E GROW LN
Mailing Address - Street 2:
Mailing Address - City:PALMER
Mailing Address - State:AK
Mailing Address - Zip Code:99645-8881
Mailing Address - Country:US
Mailing Address - Phone:907-841-2525
Mailing Address - Fax:
Practice Address - Street 1:12812 OLD GLENN HWY STE A3
Practice Address - Street 2:
Practice Address - City:EAGLE RIVER
Practice Address - State:AK
Practice Address - Zip Code:99577-7003
Practice Address - Country:US
Practice Address - Phone:907-795-8115
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-07-02
Last Update Date:2023-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPT608285252251P0200X
AK1995402251P0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics