Provider Demographics
NPI:1992173314
Name:GIELOW, KENDALL RYAN (DPT)
Entity type:Individual
Prefix:
First Name:KENDALL
Middle Name:RYAN
Last Name:GIELOW
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10550 HARBOR HILL DR NW
Mailing Address - Street 2:
Mailing Address - City:GIG HARBOR
Mailing Address - State:WA
Mailing Address - Zip Code:98332-8944
Mailing Address - Country:US
Mailing Address - Phone:253-530-8970
Mailing Address - Fax:253-858-1143
Practice Address - Street 1:10550 HARBOR HILL DR NW
Practice Address - Street 2:
Practice Address - City:GIG HARBOR
Practice Address - State:WA
Practice Address - Zip Code:98332-8944
Practice Address - Country:US
Practice Address - Phone:253-530-8970
Practice Address - Fax:253-858-1143
Is Sole Proprietor?:No
Enumeration Date:2015-09-02
Last Update Date:2015-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPT60568290225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist