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General NPI Number Information
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NPI Number | 1396361036
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Entity Type | Individual
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Provider Name | JAELYNN GRIESS PT, DPT
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Gender | Female
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Dates
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Enumeration Date | 06/18/2020
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Last Update Date | 11/13/2025
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Provider Practice Location Address
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Address Line | 54 MAUI LANI PKWY
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City | WAILUKU
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State | HI
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Zip | 96793-2467
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Country | US
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Telephone | 808-446-2032
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Fax |
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Provider Business Mailing Address
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Address Line | 1629 W AVALANCHE RD
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City | LINCOLN
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State | NE
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Zip | 68521-1698
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Country | US
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Telephone | 402-310-0474
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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 | PT-6297
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License Number State | HI
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