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General NPI Number Information
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NPI Number | 1497620587
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Entity Type | Individual
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Provider Name | JACOB FERRY
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Gender | Male
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Dates
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Enumeration Date | 10/08/2025
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Last Update Date | 10/08/2025
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Provider Practice Location Address
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Address Line | 17500 133RD AVE NE SUITE A
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City | WOODINVILLE
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State | WA
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Zip | 98072-3609
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Country | US
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Telephone | 425-286-6615
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Fax | 425-286-6649
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Provider Business Mailing Address
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Address Line | 209 KIRKLAND AVE
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City | KIRKLAND
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State | WA
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Zip | 98033-6503
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Country | US
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Telephone |
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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 | PT70032618
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License Number State | WA
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