Provider Demographics
NPI:1912963489
Name:HALEY KANIGEL, VIRGINIA CAROL (PT)
Entity Type:Individual
Prefix:
First Name:VIRGINIA
Middle Name:CAROL
Last Name:HALEY KANIGEL
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:VIRGINIA
Other - Middle Name:CAROL
Other - Last Name:HALEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:4240 W MONTFORT PL
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98199
Mailing Address - Country:US
Mailing Address - Phone:206-378-1129
Mailing Address - Fax:
Practice Address - Street 1:413 FAIRVIEW AVE N
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98109
Practice Address - Country:US
Practice Address - Phone:206-405-3560
Practice Address - Fax:206-405-3938
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA10418225100000X
CO2205225100000X
WAPT00007426225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist