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General NPI Number Information
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NPI Number | 1386808889
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Entity Type | Individual
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Provider Name | JASON P GODFREY DPT
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Gender | Male
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Dates
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Enumeration Date | 07/14/2008
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Last Update Date | 01/13/2020
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Provider Practice Location Address
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Address Line | 4915 25TH AVE NE STE 104
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City | SEATTLE
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State | WA
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Zip | 98105
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Country | US
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Telephone | 206-315-7998
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Fax | 206-316-2308
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Provider Business Mailing Address
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Address Line | 15 SW EVERETT MALL WAY STE G
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City | EVERETT
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State | WA
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Zip | 98204-2715
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Country | US
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Telephone | 425-355-5222
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Fax | 425-355-5231
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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 | 34756
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License Number State | CA
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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 | PT60844798
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License Number State | WA
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