Provider Demographics
NPI:1447287586
Name:FOSS, KRISTEN DAHL (PTA)
Entity type:Individual
Prefix:MS
First Name:KRISTEN
Middle Name:DAHL
Last Name:FOSS
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4505 N FARR RD
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99206-4406
Mailing Address - Country:US
Mailing Address - Phone:509-927-0964
Mailing Address - Fax:
Practice Address - Street 1:ST. LUKE'S REHAB
Practice Address - Street 2:711 S COWLEY
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99202
Practice Address - Country:US
Practice Address - Phone:509-473-6000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant