Individual
JONETTE FORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMP
Contact information
Practice address
9709 3RD AVE NE, SEATTLE, WA 98115-2062
(206) 860-2210
Mailing address
1145 BROADWAY, SEATTLE, WA 98122-4201
(206) 860-5414
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT60569
WA
225700000X
Massage Therapist
MA 60243151
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0354547
L & I
WA
01
—
0355286
L & I
WA
01
—
G8952318
MEDICARE
WA
01
—
G8952319
MEDICARE
WA
01
—
G8952320
MEDICARE
WA
01
—
G8952321
MEDICARE
WA
01
—
G8952322
MEDICARE
WA
Enumeration date
11/16/2011
Last updated
03/04/2024
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