Individual
JAKE PABLITO ORTEGA LUSABE II
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPT
Contact information
Practice address
1560 3RD AVE, LONGVIEW, WA 98632-3229
(866) 518-0283
Mailing address
1200 CORPORATE DR STE 400, HOOVER, AL 35242-5424
(423) 238-7217
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT.PT.61406907
WA
225100000X
Physical Therapist
Primary
PT61406907
WA
Other
Enumeration date
04/25/2026
Last updated
05/08/2026
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