Provider Demographics
NPI:1780859009
Name:FERREIRA, KATHY ANN (RPT)
Entity Type:Individual
Prefix:
First Name:KATHY
Middle Name:ANN
Last Name:FERREIRA
Suffix:
Gender:F
Credentials:RPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21804 NW 43RD AVE
Mailing Address - Street 2:
Mailing Address - City:RIDGEFIELD
Mailing Address - State:WA
Mailing Address - Zip Code:98642-8416
Mailing Address - Country:US
Mailing Address - Phone:360-887-0475
Mailing Address - Fax:
Practice Address - Street 1:21804 NW 43RD AVE
Practice Address - Street 2:
Practice Address - City:RIDGEFIELD
Practice Address - State:WA
Practice Address - Zip Code:98642-8416
Practice Address - Country:US
Practice Address - Phone:360-887-0475
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-28
Last Update Date:2008-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPT00006930225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist