Provider Demographics
NPI:1679060636
Name:DENHAM, KAILIE (DPT)
Entity type:Individual
Prefix:
First Name:KAILIE
Middle Name:
Last Name:DENHAM
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2527 E 27TH AVE STE 100
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99223-4909
Mailing Address - Country:US
Mailing Address - Phone:509-701-7651
Mailing Address - Fax:509-279-2636
Practice Address - Street 1:2527 E 27TH AVE STE 100
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99223-4909
Practice Address - Country:US
Practice Address - Phone:509-701-7651
Practice Address - Fax:509-279-2636
Is Sole Proprietor?:No
Enumeration Date:2018-04-16
Last Update Date:2018-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPT00010768225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist