Provider Demographics
NPI:1427471986
Name:WIDNER, KENDRA (DPT)
Entity type:Individual
Prefix:
First Name:KENDRA
Middle Name:
Last Name:WIDNER
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:KENDRA
Other - Middle Name:
Other - Last Name:GILBERT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1952 E 7000 S
Mailing Address - Street 2:
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84121-6877
Mailing Address - Country:US
Mailing Address - Phone:801-495-5279
Mailing Address - Fax:801-495-5303
Practice Address - Street 1:2611 S DEARBORN ST
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98144-3013
Practice Address - Country:US
Practice Address - Phone:206-325-6700
Practice Address - Fax:206-325-4088
Is Sole Proprietor?:No
Enumeration Date:2014-02-03
Last Update Date:2014-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist