MEDICARE: DR. JEAN GEORGE PT, 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
1	225100000X	Physical Therapist	23083	MD
2	225100000X	Physical Therapist	61515041	WA

General Provider Information

NPI Number	:	1336513506
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JEAN GEORGE PT, DPT

Provider Business Mailing Address
First Line	:	13104 SW 220TH ST
Second Line	:
City	:	VASHON
State	:	WA
Zip	:	98070-6334
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	9929 SW BANK RD # 101
Second Line	:
City	:	VASHON
State	:	WA
Zip	:	98070-5014
Country	:	US
Telephone Number	:	206-567-7740
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/25/2015
Last Update Date	:	03/28/2024

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