Provider Demographics
NPI:1982152419
Name:KRASNER-ROSENSTEIN, SHIRI K (PT)
Entity Type:Individual
Prefix:
First Name:SHIRI
Middle Name:K
Last Name:KRASNER-ROSENSTEIN
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:SHIRI
Other - Middle Name:K
Other - Last Name:KRASNER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:7320 216TH ST SW STE 320
Mailing Address - Street 2:
Mailing Address - City:EDMONDS
Mailing Address - State:WA
Mailing Address - Zip Code:98026-8006
Mailing Address - Country:US
Mailing Address - Phone:425-673-3900
Mailing Address - Fax:425-673-3910
Practice Address - Street 1:15808 MILL CREEK BLVD
Practice Address - Street 2:SUITE 120
Practice Address - City:MILL CREEK
Practice Address - State:WA
Practice Address - Zip Code:98012-1500
Practice Address - Country:US
Practice Address - Phone:425-298-4072
Practice Address - Fax:425-298-4076
Is Sole Proprietor?:No
Enumeration Date:2016-09-13
Last Update Date:2024-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPT00003958226300000X, 225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No226300000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersKinesiotherapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA2070204Medicaid
WA366390OtherWA LABOR & INDUSTRIES