Provider Demographics
NPI:1770464729
Name:SCHAFFRIN, JESS COLETTE
Entity type:Individual
Prefix:
First Name:JESS
Middle Name:COLETTE
Last Name:SCHAFFRIN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2110 EAGLE CREEK LN
Mailing Address - Street 2:
Mailing Address - City:WOODBURY
Mailing Address - State:MN
Mailing Address - Zip Code:55129-3205
Mailing Address - Country:US
Mailing Address - Phone:612-293-9294
Mailing Address - Fax:
Practice Address - Street 1:2110 EAGLE CREEK LN STE 400
Practice Address - Street 2:
Practice Address - City:WOODBURY
Practice Address - State:MN
Practice Address - Zip Code:55129-3209
Practice Address - Country:US
Practice Address - Phone:612-293-9294
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-09-08
Last Update Date:2025-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN1427479617225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist