Provider Demographics
NPI:1669589503
Name:KNAGENHJELM, RUTH (PT)
Entity type:Individual
Prefix:MS
First Name:RUTH
Middle Name:
Last Name:KNAGENHJELM
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 1:181 S 333RD ST STE 250
Mailing Address - Street 2:
Mailing Address - City:FEDERAL WAY
Mailing Address - State:WA
Mailing Address - Zip Code:98003-7363
Mailing Address - Country:US
Mailing Address - Phone:253-874-2998
Mailing Address - Fax:253-874-3307
Practice Address - Street 1:22659 PACIFIC HWY S
Practice Address - Street 2:
Practice Address - City:DES MOINES
Practice Address - State:WA
Practice Address - Zip Code:98198-5155
Practice Address - Country:US
Practice Address - Phone:206-824-3668
Practice Address - Fax:206-824-3964
Is Sole Proprietor?:No
Enumeration Date:2006-08-24
Last Update Date:2014-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA2519225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist