| Doctor Name: | JACK URIAH TEAGUE |
| NPI Number: | 1992845192 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | P.T. |
| License Number: | PT00000652 |
| Business Practice Address: | 18107 Bothell Way Ne Suite 106 Bothell, WA - 980111900 |
| Business Phone Number: | 4254873142 |
| Business Fax Number: | 4254878785 |
| Mailing Address: | 9209 126th Ave Ne, KIRKLAND |
| State: | WA |
| Postal Code: | 980335901 |
| Phone Number: | 4258274758 |
| Fax Number: | |
| NPI Enumeration Date: | 02/07/2007 |
| NPI Last Update Date: | 04/11/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 225100000X |
| License Number: | PT00000652 |
| 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 |