Provider Demographics
NPI:1801965827
Name:IKE, KARIE LYNN (DPT)
Entity type:Individual
Prefix:
First Name:KARIE
Middle Name:LYNN
Last Name:IKE
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:730 N. HAMILTON
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99202-1500
Mailing Address - Country:US
Mailing Address - Phone:509-458-7686
Mailing Address - Fax:509-458-6611
Practice Address - Street 1:125 S COWLEY ST
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99202-1500
Practice Address - Country:US
Practice Address - Phone:509-458-7686
Practice Address - Fax:509-458-6611
Is Sole Proprietor?:No
Enumeration Date:2006-11-06
Last Update Date:2017-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPT00010280225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA8463853Medicaid
WA0213623OtherDEPARTMENT OF LABOR & IND