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General NPI Number Information
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NPI Number | 1003300963
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Entity Type | Individual
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Provider Name | JARAD COLEMAN BRISBIN DPT
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Gender | Male
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Dates
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Enumeration Date | 06/14/2018
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Last Update Date | 10/13/2025
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Provider Practice Location Address
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Address Line | 6825 BURDEN BLVD STE D
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City | PASCO
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State | WA
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Zip | 99301-5633
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Country | US
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Telephone | 509-545-1010
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Fax |
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Provider Business Mailing Address
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Address Line | 1200 CORPORATE DR STE 400
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City | HOOVER
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State | AL
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Zip | 35242-5424
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Country | US
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Telephone | 423-702-4389
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2251S0007X
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Taxonomy Name | Sports Physical Therapist
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License Number | LPT30083
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License Number State | AZ
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Taxonomy #2
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | PT60842213
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License Number State | WA
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