Individual
JODI J PETRINOVICH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.T.
Contact information
Practice address
1901 S CEDAR ST STE B1, TACOMA, WA 98405-2305
(253) 272-6910
(253) 383-4218
Mailing address
1519 132ND ST SE, SUITE A, EVERETT, WA 98208-7203
(425) 357-9380
(425) 357-9382
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT00002847
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0197670
DEPT OF LABOR & INDUSTRY
WA
01
—
0296929
L & I
WA
05
—
8341414
—
WA
01
—
MI8360
REGENCE BLUE SHEILD
WA
01
—
P00237577
RAILROAD MEDICARE
WA
Enumeration date
09/13/2006
Last updated
08/28/2012
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