Provider Demographics
NPI:1639662935
Name:HUGHES, KELSI (PT, DPT)
Entity Type:Individual
Prefix:
First Name:KELSI
Middle Name:
Last Name:HUGHES
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 1:17255 135TH AVE NE UNIT 501
Mailing Address - Street 2:
Mailing Address - City:WOODINVILLE
Mailing Address - State:WA
Mailing Address - Zip Code:98072-5011
Mailing Address - Country:US
Mailing Address - Phone:270-313-7730
Mailing Address - Fax:
Practice Address - Street 1:7800 JOHN DAVIS DR STE 460
Practice Address - Street 2:
Practice Address - City:FRANKFORT
Practice Address - State:KY
Practice Address - Zip Code:40601-6577
Practice Address - Country:US
Practice Address - Phone:502-699-2734
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-06-11
Last Update Date:2022-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA60837912225100000X
KYPT-008517225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA2103884Medicaid