Provider Demographics
NPI:1013174424
Name:STEDMAN, KATHRYN JAYNE (PT)
Entity type:Individual
Prefix:MS
First Name:KATHRYN
Middle Name:JAYNE
Last Name:STEDMAN
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 1:13708 97TH AVE NE
Mailing Address - Street 2:
Mailing Address - City:KIRKLAND
Mailing Address - State:WA
Mailing Address - Zip Code:98034-1874
Mailing Address - Country:US
Mailing Address - Phone:425-829-2639
Mailing Address - Fax:425-823-6133
Practice Address - Street 1:40 EASTERN AVE
Practice Address - Street 2:
Practice Address - City:MALDEN
Practice Address - State:MA
Practice Address - Zip Code:02148-5014
Practice Address - Country:US
Practice Address - Phone:800-760-5196
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-05-22
Last Update Date:2008-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA0000425225100000X
OR225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist