Provider Demographics
NPI:1013328178
Name:LUE, KRYSTYNA LEE (PT, DPT)
Entity Type:Individual
Prefix:
First Name:KRYSTYNA
Middle Name:LEE
Last Name:LUE
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:KRYSTYNA
Other - Middle Name:LEE
Other - Last Name:OWENS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT, DPT
Mailing Address - Street 1:1200 CORPORATE DR STE 300
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35242-2944
Mailing Address - Country:US
Mailing Address - Phone:423-682-8840
Mailing Address - Fax:423-602-2028
Practice Address - Street 1:8354 SW NIMBUS AVE
Practice Address - Street 2:
Practice Address - City:BEAVERTON
Practice Address - State:OR
Practice Address - Zip Code:97008-6444
Practice Address - Country:US
Practice Address - Phone:971-219-4899
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-05-12
Last Update Date:2023-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist