Jody Gustafson
Physical Therapist - Pediatrics
3330 Monte Villa Pkwy
Bothell
, Washington 98021-8972
Jody Gustafson
Physical Therapist - Pediatrics
3330 Monte Villa Pkwy
Bothell
, Washington 98021-8972
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About
Features
Specialties
- Physical Therapist - Pediatrics
Languages spoken
- English
Location
First Address
- Jody Gustafson
- 19705 88th Ave Ne
- Bothell, WA
- Zip : 98011-2121
- Phone :
Second Address
- Jody Gustafson
- 3330 Monte Villa Pkwy
- Bothell, WA
- Zip : 98021-8972
- Phone : (425) 408-5570
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 2251P0200X | Physical Therapist - Pediatrics | PT 00002619 | WA |
National Provider Identifier
| NPI | 1053655860 |
|---|---|
| Provider Name | Jody Gustafson |
| First Address | Bothell, WA 98011-2121 |
| Second Address | Bothell, WA 98021-8972 |
| Gender | F |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 16/11/2012 |
| Last Update Date | 16/11/2012 |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.