Healthcare Provider Details

I. General information

NPI: 1265343719
Provider Name (Legal Business Name): JORDANA MEDNICK PT, DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/14/2026
Last Update Date: 09/14/2026
Certification Date: 09/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6500 6TH AVE NW
SEATTLE WA
98117-5099
US

IV. Provider business mailing address

132 NE 53RD ST # B
SEATTLE WA
98105-3727
US

V. Phone/Fax

Practice location:
  • Phone: 561-716-6881
  • Fax:
Mailing address:
  • Phone: 561-716-6881
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberT.PT.70163498
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: