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General NPI Number Information
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NPI Number | 1801760525
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Entity Type | Individual
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Provider Name | JENNIFER BEAVERSON PT
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Gender | Female
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Dates
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Enumeration Date | 10/04/2025
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Last Update Date | 10/04/2025
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Provider Practice Location Address
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Address Line | 20818 44TH AVE W STE 270
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City | LYNNWOOD
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State | WA
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Zip | 98036-7709
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Country | US
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Telephone | 425-672-9219
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Fax |
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Provider Business Mailing Address
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Address Line | 7751 38TH AVE NE
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City | SEATTLE
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State | WA
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Zip | 98115-4907
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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 | PT61686453
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License Number State | WA
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