Provider Demographics
NPI:1144875352
Name:MILLER, KAITLYN ELIZABETH (DPT)
Entity type:Individual
Prefix:MS
First Name:KAITLYN
Middle Name:ELIZABETH
Last Name:MILLER
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:KAITLYN
Other - Middle Name:ELIZABETH
Other - Last Name:BARR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2400 NW MYHRE RD STE 101
Mailing Address - Street 2:
Mailing Address - City:SILVERDALE
Mailing Address - State:WA
Mailing Address - Zip Code:98383
Mailing Address - Country:US
Mailing Address - Phone:360-598-3764
Mailing Address - Fax:360-598-3282
Practice Address - Street 1:945 HILDEBRAND LANE NE #220
Practice Address - Street 2:
Practice Address - City:BAINBRIDGE ISLAND
Practice Address - State:WA
Practice Address - Zip Code:98110
Practice Address - Country:US
Practice Address - Phone:206-842-6288
Practice Address - Fax:206-842-6292
Is Sole Proprietor?:No
Enumeration Date:2019-08-05
Last Update Date:2023-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPT60943935225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist