Individual
MR. JEREMY B CALKINS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
16101 64TH ST E, SUMNER, WA 98390-3069
(253) 891-7490
(253) 863-1052
Mailing address
16101 64TH ST E, SUMNER, WA 98390-3069
(253) 891-7490
(253) 863-1052
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT00009199
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
192087
DEPT OF L&I
WA
01
—
4822CA
REGENCE BS
WA
01
—
7780484
AETNA
WA
05
—
8368961
—
WA
01
—
8939557
CRIME VICTIMS
WA
Enumeration date
08/18/2005
Last updated
10/20/2015
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