Provider Demographics
NPI:1992224539
Name:ESCHBACH, KATELYN (PT)
Entity Type:Individual
Prefix:
First Name:KATELYN
Middle Name:
Last Name:ESCHBACH
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:KATELYN
Other - Middle Name:
Other - Last Name:RATLIFF
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:790 REMINGTON BLVD
Mailing Address - Street 2:
Mailing Address - City:BOLINGBROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60440-4909
Mailing Address - Country:US
Mailing Address - Phone:630-296-2222
Mailing Address - Fax:
Practice Address - Street 1:3315 S 23RD ST STE 210
Practice Address - Street 2:
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98405-1616
Practice Address - Country:US
Practice Address - Phone:425-820-0869
Practice Address - Fax:425-820-1745
Is Sole Proprietor?:No
Enumeration Date:2017-09-14
Last Update Date:2017-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPT60745588225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist