Individual
JEFFREY NIEDZINSKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MPT
Contact information
Practice address
3912 10TH ST SE, SUITE 101, PUYALLUP, WA 98374-2188
(253) 848-4700
(253) 848-2284
Mailing address
PO BOX 731269, PUYALLUP, WA 98373-0060
(253) 840-2313
(253) 840-6340
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT00008412
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
194291
DEPT OF LABOR & INDUSTRY
WA
05
—
8416075
—
WA
01
—
8554NI
REGENCE BLUE SHIELD
WA
01
—
8851151
PIERCE COUNTY
WA
01
—
8939972
CRIME VICTIMS
WA
Enumeration date
11/09/2006
Last updated
07/08/2007
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