Provider Demographics
NPI:1902320567
Name:NINOMIYA, KATHERINE (PT, DPT, OCS FAAOMPT)
Entity Type:Individual
Prefix:
First Name:KATHERINE
Middle Name:
Last Name:NINOMIYA
Suffix:
Gender:F
Credentials:PT, DPT, OCS FAAOMPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2901 3RD AVE STE 520
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98121-3014
Mailing Address - Country:US
Mailing Address - Phone:206-686-4073
Mailing Address - Fax:
Practice Address - Street 1:2901 3RD AVE STE 350
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98121-1031
Practice Address - Country:US
Practice Address - Phone:206-686-4073
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-07-26
Last Update Date:2024-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPT60765904208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation