Provider Demographics
NPI:1730627423
Name:JONES, JESSICA NICOLE (PT, DPT)
Entity type:Individual
Prefix:
First Name:JESSICA
Middle Name:NICOLE
Last Name:JONES
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 1:2801 WESTERN AVE APT 609
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98121-1196
Mailing Address - Country:US
Mailing Address - Phone:774-279-6285
Mailing Address - Fax:
Practice Address - Street 1:508 1ST AVE N
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98109-4522
Practice Address - Country:US
Practice Address - Phone:206-895-7535
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-02-02
Last Update Date:2024-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA22722225100000X
WAPT61459977225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist