Provider Demographics
NPI:1285160952
Name:MANUSE, KATE E (DPT, GCS)
Entity type:Individual
Prefix:
First Name:KATE
Middle Name:E
Last Name:MANUSE
Suffix:
Gender:F
Credentials:DPT, GCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1405 SE 125TH AVE
Mailing Address - Street 2:
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98683-6329
Mailing Address - Country:US
Mailing Address - Phone:503-719-3178
Mailing Address - Fax:
Practice Address - Street 1:18414 NE GARDEN DR
Practice Address - Street 2:
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98682-3612
Practice Address - Country:US
Practice Address - Phone:503-810-0837
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-05-02
Last Update Date:2017-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPT 60167555225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist