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General NPI Number Information
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NPI Number | 1659759967
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Entity Type | Individual
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Provider Name | JESSICA KREPPS PTA
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Gender | Female
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Dates
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Enumeration Date | 05/07/2015
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Last Update Date | 12/10/2024
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Provider Practice Location Address
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Address Line | 16201 25TH AVE W
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City | LYNNWOOD
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State | WA
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Zip | 98087-2520
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Country | US
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Telephone | 425-774-9564
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Fax |
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Provider Business Mailing Address
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Address Line | 19335 132ND PL NE
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City | WOODINVILLE
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State | WA
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Zip | 98072-8773
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Country | US
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Telephone | 206-941-5373
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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 | 225200000X
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Taxonomy Name | Physical Therapy Assistant
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License Number | 160546986
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License Number State | WA
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