NPI 1053655860

Jody Gustafson

Practitioner Pediatric Physical Therapist Bothell, WA

Practice location

Address: 3330 Monte Villa Pkwy, Bothell, WA 98021-8972
Phone: (425) 408-5570
Mailing address: 19705 88th Ave NE, Bothell, WA 98011-2121

Registered specialties

Pediatric Physical Therapist Primary

Respiratory, Developmental, Rehabilitative and Restorative Service Providers Taxonomy 2251P0200X Licence PT 00002619 (WA)

Other Physical Therapist providers in Washington →

Registry record

NPI: 1053655860
Entity type: Individual
Sex (as registered): Female
NPI issued: 16 Nov 2012
Record last updated: 16 Nov 2012

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.