Doctor Name: | JENNA BOERBOOM |
NPI Number: | 1669665626 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | DPT |
License Number: | PT00010556 |
Business Practice Address: | 17650 140th Ave Se #b-07 Renton, WA - 980586814 |
Business Phone Number: | 4254300700 |
Business Fax Number: | 4254300710 |
Mailing Address: | 244 118th Ave Se, Apt 28 BELLEVUE |
State: | WA |
Postal Code: | 980053560 |
Phone Number: | 3192704756 |
Fax Number: | |
NPI Enumeration Date: | 08/23/2007 |
NPI Last Update Date: | 04/01/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225100000X |
License Number: | PT00010556 |
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 |