Provider Demographics
NPI:1922211689
Name:LAWLEY, KATHY LYNN (PT)
Entity Type:Individual
Prefix:
First Name:KATHY
Middle Name:LYNN
Last Name:LAWLEY
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:PO BOX 266
Mailing Address - Street 2:
Mailing Address - City:BEAVER
Mailing Address - State:WA
Mailing Address - Zip Code:98305-0266
Mailing Address - Country:US
Mailing Address - Phone:360-327-3880
Mailing Address - Fax:360-327-3885
Practice Address - Street 1:286 GROUSE GLEN WAY
Practice Address - Street 2:
Practice Address - City:PORT ANGELES
Practice Address - State:WA
Practice Address - Zip Code:98363
Practice Address - Country:US
Practice Address - Phone:360-327-3880
Practice Address - Fax:360-327-3885
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-08
Last Update Date:2008-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPT00006875225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist