Provider Demographics
NPI:1841574902
Name:PATTERSON, KRISTEN (DPT)
Entity Type:Individual
Prefix:
First Name:KRISTEN
Middle Name:
Last Name:PATTERSON
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2044 GOLF COURSE DR
Mailing Address - Street 2:
Mailing Address - City:RESTON
Mailing Address - State:VA
Mailing Address - Zip Code:20191-3820
Mailing Address - Country:US
Mailing Address - Phone:843-819-7211
Mailing Address - Fax:
Practice Address - Street 1:6858 OLD DOMINION DR
Practice Address - Street 2:SUITE 200
Practice Address - City:MC LEAN
Practice Address - State:VA
Practice Address - Zip Code:22101-3899
Practice Address - Country:US
Practice Address - Phone:703-288-8277
Practice Address - Fax:703-288-9316
Is Sole Proprietor?:No
Enumeration Date:2011-10-06
Last Update Date:2013-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2305206567225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA2305206567OtherVIRGINIA BOARD OF PHYSICAL THERAPY
MD23800OtherPHYSICAL THERAPY BOARD OF MD