| Doctor Name: | JACK M STAGGE |
| NPI Number: | 1275657355 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | P.T., O.C.S., |
| License Number: | PT00005726 |
| Business Practice Address: | 230 Grant Road, Suite B27 East Wenatchee, WA - 98802 |
| Business Phone Number: | 5098841437 |
| Business Fax Number: | 5098842811 |
| Mailing Address: | 2810 Riverwalk Place, EAST WENATCHEE |
| State: | WA |
| Postal Code: | 98802 |
| Phone Number: | 5098842992 |
| Fax Number: | |
| NPI Enumeration Date: | 03/16/2007 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 225100000X |
| License Number: | PT00005726 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | WA |
| Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Taxonomy Classification: | Physical Therapist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | (1) Physical therapists are health care professionals who evaluate and treat people with health problems resulting from injury or disease. PT |