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NPI Code Detail

MEDICARE: JENNIFER LYN WELCH DPT

MEDICARE: JENNIFER LYN WELCH DPT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225100000XPhysical TherapistPT00010198WA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1PT00010198OTHERWAPHYSICAL THERAPIST LICENS

General Provider Information

NPI Number : 1619080652
Entity Type Code : Individual
Provider Name (Legal Business Name) : JENNIFER LYN WELCH DPT
Provider Business Mailing Address
First Line : 3411 36TH AVE S
Second Line :
City : SEATTLE
State : WA
Zip : 98144-7104
Country : US
Telephone Number : 253-232-7421
Fax Number :
Provider Business Practice Location Address
First Line : 7500 SEWARD PARK AVE S
Second Line :
City : SEATTLE
State : WA
Zip : 98118-4247
Country : US
Telephone Number : 253-232-7421
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/16/2006
Last Update Date : 08/17/2012

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