Provider Demographics
NPI:1922032838
Name:WOKEN, KATHLEEN H (PT)
Entity Type:Individual
Prefix:
First Name:KATHLEEN
Middle Name:H
Last Name:WOKEN
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 1:2990 SETER PKWY S
Mailing Address - Street 2:
Mailing Address - City:FARGO
Mailing Address - State:ND
Mailing Address - Zip Code:58104-8692
Mailing Address - Country:US
Mailing Address - Phone:701-234-8385
Mailing Address - Fax:701-234-8944
Practice Address - Street 1:2990 SETER PKWY S
Practice Address - Street 2:
Practice Address - City:FARGO
Practice Address - State:ND
Practice Address - Zip Code:58104-8692
Practice Address - Country:US
Practice Address - Phone:701-234-8385
Practice Address - Fax:701-234-8944
Is Sole Proprietor?:No
Enumeration Date:2006-07-10
Last Update Date:2014-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND814225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NDND200015OtherLHS #
NDHP38647OtherHEALTHPARTNERS #
ND23745OtherAMERICA'S PPO/ARAZ #
ND6401695OtherMEDICA #
ND63D89WOOtherMNBS #
ND6402107OtherMEDICA #
NDDA9011015523OtherPREFERRED ONE #
ND63D89WOOtherMNBS #
ND6401695OtherMEDICA #
ND23745OtherAMERICA'S PPO/ARAZ #