Provider Demographics
NPI:1861408924
Name:WAIT, JENNIFER CATHERINE (PT)
Entity type:Individual
Prefix:MRS
First Name:JENNIFER
Middle Name:CATHERINE
Last Name:WAIT
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
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Mailing Address - Street 1:8020 ROBE MENZEL RD
Mailing Address - Street 2:
Mailing Address - City:GRANITE FALLS
Mailing Address - State:WA
Mailing Address - Zip Code:98252-9704
Mailing Address - Country:US
Mailing Address - Phone:360-691-7892
Mailing Address - Fax:425-258-7600
Practice Address - Street 1:916 PACIFIC AVE
Practice Address - Street 2:
Practice Address - City:EVERETT
Practice Address - State:WA
Practice Address - Zip Code:98201-4147
Practice Address - Country:US
Practice Address - Phone:425-258-7600
Practice Address - Fax:425-258-7406
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WA00007170225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist