Healthcare Provider Details

I. General information

NPI: 1306628847
Provider Name (Legal Business Name): WEST SEATTLE PELVIC HEALTH & PT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/18/2023
Last Update Date: 10/18/2023
Certification Date: 10/18/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3270 CALIFORNIA AVE SW
SEATTLE WA
98116-3305
US

IV. Provider business mailing address

4417 46TH AVE SW
SEATTLE WA
98116-4127
US

V. Phone/Fax

Practice location:
  • Phone: 206-228-4023
  • Fax:
Mailing address:
  • Phone: 206-228-4023
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. LAURA JEWETT
Title or Position: OWNER
Credential: DPT
Phone: 206-228-4023