Individual
JEANNE LYNN DEMEULENAERE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BA MPT
Contact information
Practice address
451 SW SEDGWICK RD, SUITE 310, PORT ORCHARD, WA 98367-6425
(360) 874-8009
(360) 874-8010
Mailing address
4040 ORCHARD ST W, SUITE 100, FIRCREST, WA 98466-6606
(253) 564-1560
(253) 564-4449
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT00009062
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8350191
—
WA
Enumeration date
05/08/2006
Last updated
10/08/2007
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