| Doctor Name: | JEREMY CORNWELL |
| NPI Number: | 1770897274 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | DPT |
| License Number: | PT60041805 |
| Business Practice Address: | 11700 Mukilteo Speedway Suite 503 Mukilteo, WA - 982755432 |
| Business Phone Number: | 4253499692 |
| Business Fax Number: | 4253499694 |
| Mailing Address: | 4220 132nd St Se, Suite101 MILL CREEK |
| State: | WA |
| Postal Code: | 980128999 |
| Phone Number: | 4253579380 |
| Fax Number: | 4253579382 |
| NPI Enumeration Date: | 07/27/2010 |
| NPI Last Update Date: | 12/03/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 225100000X |
| License Number: | PT60041805 |
| 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 |