| Doctor Name: | MR. KEVIN P GRAHAM |
| NPI Number: | 1205977386 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | PT |
| License Number: | PT00003966 |
| Business Practice Address: | 9514 4th St Ne Suite 101 Lake Stevens, WA - 982581937 |
| Business Phone Number: | 4253972327 |
| Business Fax Number: | 4253770283 |
| Mailing Address: | 10505 19th Ave Se, Suite B EVERETT |
| State: | WA |
| Postal Code: | 982084280 |
| Phone Number: | 4085700510 |
| Fax Number: | 4089454018 |
| NPI Enumeration Date: | 02/09/2007 |
| NPI Last Update Date: | 03/13/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 225100000X |
| License Number: | PT00003966 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | WA |
| Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Taxonomy Classification: | Physical Therapist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | (1) Physical therapists are health care professionals who evaluate and treat people with health problems resulting from injury or disease. PT |