Provider Demographics
NPI:1457411746
Name:KACHMARIK, BETSY ANN (PT)
Entity Type:Individual
Prefix:
First Name:BETSY
Middle Name:ANN
Last Name:KACHMARIK
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 1:20214 130TH CT NE
Mailing Address - Street 2:
Mailing Address - City:WOODINVILLE
Mailing Address - State:WA
Mailing Address - Zip Code:98072-8725
Mailing Address - Country:US
Mailing Address - Phone:425-485-6385
Mailing Address - Fax:
Practice Address - Street 1:17311 135TH AVE NE
Practice Address - Street 2:C-200
Practice Address - City:WOODINVILLE
Practice Address - State:WA
Practice Address - Zip Code:98072-3519
Practice Address - Country:US
Practice Address - Phone:425-486-7710
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPT00005343225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist