Provider Demographics
NPI:1790521300
Name:HEAVENLY TOUCH PHYSICAL THERAPY PLLC
Entity type:Organization
Organization Name:HEAVENLY TOUCH PHYSICAL THERAPY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICAL THERAPISST
Authorized Official - Prefix:
Authorized Official - First Name:SHARONDA
Authorized Official - Middle Name:
Authorized Official - Last Name:JENKINS
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:202-271-1037
Mailing Address - Street 1:516 NE 103RD ST APT D214
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98125-7456
Mailing Address - Country:US
Mailing Address - Phone:202-271-1037
Mailing Address - Fax:
Practice Address - Street 1:516 NE 103RD ST APT D214
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98125-7456
Practice Address - Country:US
Practice Address - Phone:202-271-1037
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-07-02
Last Update Date:2024-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedicGroup - Single Specialty