Basic Information
Provider Information
NPI: 1518976182
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: TURNIPSEED
FirstName: JERRY
MiddleName: SCOTT
NamePrefix: MR.
NameSuffix:  
Credential: PT
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName: TURNIPSEED
OtherFirstName: J.
OtherMiddleName: SCOTT
OtherNamePrefix: MR.
OtherNameSuffix:  
OtherCredential: PT
OtherLastNameType: 5
Mailing Information
Address1: 805 MADISON ST
Address2: SUITE 901
City: SEATTLE
State: WA
PostalCode: 981041172
CountryCode: US
TelephoneNumber: 2062648100
FaxNumber:  
Practice Location
Address1: 2409 N 45TH ST
Address2:  
City: SEATTLE
State: WA
PostalCode: 981036907
CountryCode: US
TelephoneNumber: 2066338100
FaxNumber:  
Other Information
ProviderEnumerationDate: 08/05/2006
LastUpdateDate: 12/12/2014
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
225100000XPT00007512WAY Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist 

No ID Information.


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