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NPI Code Detail

MEDICARE: DR. SHARONDA T JENKINS DPT, FMT

MEDICARE: DR. SHARONDA T JENKINS DPT, FMT
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 TherapistPT871825DC
2225100000XPhysical TherapistPT61429052WA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1K949 - 0078OTHERDCCAREFIRST

General Provider Information

NPI Number : 1235515230
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. SHARONDA T JENKINS DPT, FMT
Provider Business Mailing Address
First Line : 5025 25TH AVE NE STE 201
Second Line :
City : SEATTLE
State : WA
Zip : 98105-4152
Country : US
Telephone Number : 206-524-6702
Fax Number : 206-524-6703
Provider Business Practice Location Address
First Line : 5025 25TH AVE NE STE 201
Second Line :
City : SEATTLE
State : WA
Zip : 98105-4152
Country : US
Telephone Number : 206-524-6702
Fax Number : 206-524-6703
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/03/2015
Last Update Date : 01/20/2024

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