Provider Demographics
NPI:1144112046
Name:KINSEY, MIKAYLA BRIANNE (PT, DPT)
Entity type:Individual
Prefix:
First Name:MIKAYLA
Middle Name:BRIANNE
Last Name:KINSEY
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3802 S NEWPORT ST
Mailing Address - Street 2:
Mailing Address - City:KENNEWICK
Mailing Address - State:WA
Mailing Address - Zip Code:99337-3833
Mailing Address - Country:US
Mailing Address - Phone:509-438-5052
Mailing Address - Fax:
Practice Address - Street 1:17515 CANYON PARKWAY E
Practice Address - Street 2:
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98446
Practice Address - Country:US
Practice Address - Phone:253-330-8661
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-07-16
Last Update Date:2025-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist