Individual
JEREMY CORNWELL
Active
Individual
JEREMY CORNWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPT
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT60041805
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0266242
DEPT OF L&I
WA
01
—
0266257
DEPT OF L&I
WA
01
—
0266279
DEPT OF L&I
WA
01
—
0597CO
REGENCE
WA
01
—
0598CO
REGENCE
WA
01
—
0599CO
REGENCE
WA
01
—
0603CO
REGENCE
WA
01
—
0605CO
REGENCE
WA
01
—
0645CO
REGENCE
WA
01
—
0695CO
REGENCE
WA
01
—
P00893790
RAILROAD MEDICARE
WA
Enumeration date
07/27/2010
Last updated
07/14/2023
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