Individual
JACOB JOHN KMIECIK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPT
Contact information
Practice address
1218 3RD AVE STE 104, SEATTLE, WA 98101-3008
(206) 447-2220
(206) 447-2228
Mailing address
5450 LEARY AVE NW APT 643, SEATTLE, WA 98107-4081
(402) 350-3146
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT60852959
WA
Other
Enumeration date
08/15/2018
Last updated
08/15/2018
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