Provider Demographics
NPI:1336901487
Name:ABRAMS, KIARA CONNIE (DPT)
Entity type:Individual
Prefix:
First Name:KIARA
Middle Name:CONNIE
Last Name:ABRAMS
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21651 E COUNTRY VISTA DR
Mailing Address - Street 2:
Mailing Address - City:LIBERTY LAKE
Mailing Address - State:WA
Mailing Address - Zip Code:99019-7708
Mailing Address - Country:US
Mailing Address - Phone:509-822-7834
Mailing Address - Fax:
Practice Address - Street 1:21651 E COUNTRY VISTA DR
Practice Address - Street 2:
Practice Address - City:LIBERTY LAKE
Practice Address - State:WA
Practice Address - Zip Code:99019-7708
Practice Address - Country:US
Practice Address - Phone:509-822-7834
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-01-24
Last Update Date:2024-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA61447345225100000X
MT27137225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist