Provider Demographics
NPI:1639292253
Name:DUTCHER, KRISTI ANN (PT)
Entity Type:Individual
Prefix:MS
First Name:KRISTI
Middle Name:ANN
Last Name:DUTCHER
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 1:3925 NE 45TH
Mailing Address - Street 2:#312
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98105
Mailing Address - Country:US
Mailing Address - Phone:206-525-1583
Mailing Address - Fax:
Practice Address - Street 1:1600 E JEFFERSON
Practice Address - Street 2:SUTIE A 5
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98122
Practice Address - Country:US
Practice Address - Phone:206-320-8077
Practice Address - Fax:206-320-4747
Is Sole Proprietor?:No
Enumeration Date:2007-04-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPT00002212225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist