Healthcare Provider Details

I. General information

NPI: 1437134244
Provider Name (Legal Business Name): JEFFREY SCOTT VANDER LINDEN DPT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/14/2005
Last Update Date: 05/18/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8750 GREENWOOD AVE N SUITE S-1
SEATTLE WA
98103
US

IV. Provider business mailing address

P.O. BOX 11009
OLYMPIA WA
98508
US

V. Phone/Fax

Practice location:
  • Phone: 206-782-5789
  • Fax: 206-782-5794
Mailing address:
  • Phone: 800-682-2037
  • Fax: 360-464-4851

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT00009600
License Number StateWA
# 2
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT00009335
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: