Provider Demographics
NPI:1538533385
Name:WARTINGER, KAYLA (PT, DPT)
Entity type:Individual
Prefix:
First Name:KAYLA
Middle Name:
Last Name:WARTINGER
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:KAYLA
Other - Middle Name:
Other - Last Name:GASTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:9514 4TH ST NE UNIT 101
Mailing Address - Street 2:
Mailing Address - City:LAKE STEVENS
Mailing Address - State:WA
Mailing Address - Zip Code:98258-1937
Mailing Address - Country:US
Mailing Address - Phone:425-397-2327
Mailing Address - Fax:
Practice Address - Street 1:1819 S LAKE STEVENS RD UNIT E
Practice Address - Street 2:
Practice Address - City:LAKE STEVENS
Practice Address - State:WA
Practice Address - Zip Code:98258-2060
Practice Address - Country:US
Practice Address - Phone:425-334-1122
Practice Address - Fax:425-334-1188
Is Sole Proprietor?:No
Enumeration Date:2015-11-17
Last Update Date:2019-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPT60566694225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist