Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225100000X | Physical Therapist | 8342 | WA |
N | 2251E1200X | Ergonomics | 8342 | WA |
N | 225XE1200X | Ergonomics | 8342 | WA |
N | 2251N0400X | Physical Therapist - Neurology | 8342 | WA |
N | 2251X0800X | Physical Therapist - Orthopedic | 8342 | WA |
NPI | 1346480852 |
---|---|
Provider Name | Jill Jandreau |
First Address | Seattle, WA 98175-0324 |
Second Address | Seattle, WA 98125-6171 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 23/02/2009 |
Last Update Date | 17/12/2010 |