Provider Demographics
NPI:1811127939
Name:SUTTER, KELSEY METCALFE (DPT)
Entity type:Individual
Prefix:
First Name:KELSEY
Middle Name:METCALFE
Last Name:SUTTER
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 1:12040 NE 128TH ST # MS 103
Mailing Address - Street 2:
Mailing Address - City:KIRKLAND
Mailing Address - State:WA
Mailing Address - Zip Code:98034-3013
Mailing Address - Country:US
Mailing Address - Phone:425-899-3300
Mailing Address - Fax:408-945-4018
Practice Address - Street 1:12040 NE 128TH ST # MS 103
Practice Address - Street 2:
Practice Address - City:KIRKLAND
Practice Address - State:WA
Practice Address - Zip Code:98034-3013
Practice Address - Country:US
Practice Address - Phone:425-899-3300
Practice Address - Fax:408-945-4018
Is Sole Proprietor?:No
Enumeration Date:2009-07-23
Last Update Date:2024-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA8884366Medicare PIN