Provider Demographics
NPI:1780820043
Name:MORGAN, KRISTIN LYNN (PT)
Entity Type:Individual
Prefix:
First Name:KRISTIN
Middle Name:LYNN
Last Name:MORGAN
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 1:220 W WENTWORTH RD
Mailing Address - Street 2:
Mailing Address - City:ROSALIA
Mailing Address - State:WA
Mailing Address - Zip Code:99170-9755
Mailing Address - Country:US
Mailing Address - Phone:509-523-3330
Mailing Address - Fax:
Practice Address - Street 1:1150 W FAIRVIEW ST
Practice Address - Street 2:
Practice Address - City:COLFAX
Practice Address - State:WA
Practice Address - Zip Code:99111-9580
Practice Address - Country:US
Practice Address - Phone:509-397-4603
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-12-16
Last Update Date:2008-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPT00003757225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist