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General NPI Number Information
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NPI Number | 1528272374
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Entity Type | Individual
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Provider Name | JAIME RAE NEPHEW PT, DPT
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Gender | Female
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Dates
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Enumeration Date | 05/10/2007
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Last Update Date | 01/13/2010
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Provider Practice Location Address
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Address Line | 2100 LAKE WASHINGTON BLVD N UNIT L-103
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City | RENTON
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State | WA
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Zip | 98056-1449
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Country | US
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Telephone | 956-337-6299
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Fax | 425-656-5419
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Provider Business Mailing Address
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Address Line | 2100 LAKE WASHINGTON BLVD N UNIT L-103
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City | RENTON
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State | WA
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Zip | 98056-1449
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Country | US
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Telephone | 956-337-6299
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Fax | 425-656-5419
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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 | PT60129132
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License Number State | WA
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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 | 1148367
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License Number State | TX
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