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General NPI Number Information
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NPI Number | 1093694713
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Entity Type | Individual
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Provider Name | JESSICA DOUGHTY DPT, PT
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Gender | Female
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Dates
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Enumeration Date | 08/27/2025
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Last Update Date | 08/27/2025
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Provider Practice Location Address
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Address Line | 2715 LILAC ST
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City | LONGVIEW
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State | WA
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Zip | 98632-3526
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Country | US
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Telephone | 360-575-7019
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Fax |
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Provider Business Mailing Address
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Address Line | 118 SYCAMORE DR
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City | NORWALK
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State | OH
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Zip | 44857-1941
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Country | US
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Telephone | 419-575-3503
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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 | 2251P0200X
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Taxonomy Name | Pediatric Physical Therapist
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License Number |
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License Number State | WA
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