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General NPI Number Information
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NPI Number | 1003868688
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Entity Type | Individual
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Provider Name | JASON Q AVAKIAN PT
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Gender | Male
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Dates
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Enumeration Date | 05/16/2006
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Last Update Date | 07/09/2018
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Provider Practice Location Address
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Address Line | 9414 E SAN SALVADOR DR STE 140
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City | SCOTTSDALE
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State | AZ
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Zip | 85258
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Country | US
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Telephone | 480-867-1254
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Fax |
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Provider Business Mailing Address
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Address Line | 9414 E SAN SALVADOR DR STE 140
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City | SCOTTSDALE
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State | AZ
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Zip | 85258-5527
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Country | US
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Telephone | 480-867-1254
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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 | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | PT00008249
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License Number State | WA
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