Provider Demographics
NPI:1881657450
Name:CAPLES, KATHLEEN (MPT)
Entity Type:Individual
Prefix:
First Name:KATHLEEN
Middle Name:
Last Name:CAPLES
Suffix:
Gender:F
Credentials:MPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4701 SW ADMIRAL WAY # 402
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98116-2340
Mailing Address - Country:US
Mailing Address - Phone:206-972-5978
Mailing Address - Fax:206-322-9169
Practice Address - Street 1:1125 E OLIVE ST STE B
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98122-8406
Practice Address - Country:US
Practice Address - Phone:206-972-5978
Practice Address - Fax:206-322-9169
Is Sole Proprietor?:No
Enumeration Date:2006-04-06
Last Update Date:2020-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPT00009149225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAGAB39289Medicare PIN
WAG8907969Medicare PIN