Provider Demographics
NPI:1801826318
Name:DANIELS, KELLY A (MPT)
Entity Type:Individual
Prefix:MRS
First Name:KELLY
Middle Name:A
Last Name:DANIELS
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Gender:F
Credentials:MPT
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Mailing Address - Street 1:11481 SW HALL BV STE 201
Mailing Address - Street 2:THERAPEUTIC ASSOCIATES INC
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97223-8403
Mailing Address - Country:US
Mailing Address - Phone:800-219-8835
Mailing Address - Fax:503-443-1402
Practice Address - Street 1:19119 NORTH CREEK PKWY SUITE 107
Practice Address - Street 2:TAI - CANYON PARK SPORT & SPINE PHYSICAL THERAPY
Practice Address - City:BOTHELL
Practice Address - State:WA
Practice Address - Zip Code:98011-8036
Practice Address - Country:US
Practice Address - Phone:425-489-3420
Practice Address - Fax:425-489-3421
Is Sole Proprietor?:No
Enumeration Date:2006-07-03
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
WAPT00008292225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist