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General NPI Number Information
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NPI Number | 1790508984
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Entity Type | Individual
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Provider Name | AMELIA VALERIE JURKOWSKA PTA
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Gender | Female
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Dates
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Enumeration Date | 11/05/2024
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Last Update Date | 11/05/2024
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Provider Practice Location Address
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Address Line | 315 N FRENCH AVE
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City | ARLINGTON
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State | WA
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Zip | 98223-1317
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Country | US
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Telephone | 360-618-6200
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Fax |
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Provider Business Mailing Address
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Address Line | 1930 268TH ST NW
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City | STANWOOD
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State | WA
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Zip | 98292-9449
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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 | 225200000X
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Taxonomy Name | Physical Therapy Assistant
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License Number | 06811789
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License Number State | WA
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