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General NPI Number Information
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NPI Number | 1518531144
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Entity Type | Individual
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Provider Name | JACOB KAMPS DPT
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Gender | Male
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Dates
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Enumeration Date | 05/18/2021
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Last Update Date | 12/01/2025
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Provider Practice Location Address
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Address Line | 1824 FRONT ST STE A
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City | LYNDEN
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State | WA
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Zip | 98264-1729
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Country | US
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Telephone | 360-354-0585
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Fax | 360-354-1098
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Provider Business Mailing Address
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Address Line | 12087 CHINOOK DR
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City | BURLINGTON
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State | WA
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Zip | 98233-2622
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Country | US
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Telephone | 360-630-8476
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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 | 31798
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License Number State | AZ
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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 |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | PT61466277
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License Number State | WA
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