Provider Demographics
NPI:1386486686
Name:DEBOS, CAITLYNN JEAN (DPT)
Entity type:Individual
Prefix:
First Name:CAITLYNN
Middle Name:JEAN
Last Name:DEBOS
Suffix:
Gender:
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1263 WOODFOREST ST NW
Mailing Address - Street 2:
Mailing Address - City:MASSILLON
Mailing Address - State:OH
Mailing Address - Zip Code:44647-8648
Mailing Address - Country:US
Mailing Address - Phone:330-806-5488
Mailing Address - Fax:
Practice Address - Street 1:22415 68TH AVE S
Practice Address - Street 2:
Practice Address - City:KENT
Practice Address - State:WA
Practice Address - Zip Code:98032-2444
Practice Address - Country:US
Practice Address - Phone:253-395-1131
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-06-10
Last Update Date:2025-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VACP032007T225100000X
OHPT021108225100000X
WACP043373T225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist