Doctor Name: | MR. CODY THOMAS KENISON |
NPI Number: | 1215131529 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | D.P.T. |
License Number: | PT60099101 |
Business Practice Address: | 2000 Hewitt Ave Suite 115 Everett, WA - 982013600 |
Business Phone Number: | 4252523908 |
Business Fax Number: | 4252527940 |
Mailing Address: | 4220 132nd St Se, Suite101 MILL CREEK |
State: | WA |
Postal Code: | 980128999 |
Phone Number: | 4253579380 |
Fax Number: | 4253579382 |
NPI Enumeration Date: | 06/12/2007 |
NPI Last Update Date: | 03/17/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225100000X |
License Number: | PT60099101 |
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 |