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NPI Code Detail

MEDICARE: JENECA LEA THOMAS DPT

MEDICARE: JENECA LEA THOMAS DPT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225100000XPhysical Therapist

General Provider Information

NPI Number : 1124406558
Entity Type Code : Individual
Provider Name (Legal Business Name) : JENECA LEA THOMAS DPT
Provider Business Mailing Address
First Line : 17403 43RD DR NW
Second Line :
City : STANWOOD
State : WA
Zip : 98292-7993
Country : US
Telephone Number : 425-923-4496
Fax Number :
Provider Business Practice Location Address
First Line : 402 91ST AVE NE
Second Line :
City : LAKE STEVENS
State : WA
Zip : 98258-2530
Country : US
Telephone Number : 425-261-9827
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/18/2015
Last Update Date : 02/11/2021

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Directions to “ JENECA LEA THOMAS DPT” Practice Location

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