Healthcare Provider Details

I. General information

NPI: 1194646117
Provider Name (Legal Business Name): COBY PERFORMANCE PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/24/2026
Last Update Date: 07/24/2026
Certification Date: 07/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3815 N FRACE AVE
TACOMA WA
98407-1113
US

IV. Provider business mailing address

3815 N FRACE AVE
TACOMA WA
98407-1113
US

V. Phone/Fax

Practice location:
  • Phone: 253-970-2241
  • Fax:
Mailing address:
  • Phone: 253-970-2241
  • 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: JORDAN COBY
Title or Position: LICENSED PHYSICAL THERAPIST
Credential: DPT, PT
Phone: 253-970-2241