Provider Demographics
NPI:1912723073
Name:KENDALL, ERICA TA (DPT)
Entity type:Individual
Prefix:
First Name:ERICA
Middle Name:TA
Last Name:KENDALL
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 1:5117 OLIVE AVE SE
Mailing Address - Street 2:
Mailing Address - City:AUBURN
Mailing Address - State:WA
Mailing Address - Zip Code:98092-8789
Mailing Address - Country:US
Mailing Address - Phone:253-886-9122
Mailing Address - Fax:
Practice Address - Street 1:5117 OLIVE AVE SE
Practice Address - Street 2:
Practice Address - City:AUBURN
Practice Address - State:WA
Practice Address - Zip Code:98092-8789
Practice Address - Country:US
Practice Address - Phone:253-886-9122
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-11-22
Last Update Date:2024-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist