Individual
ANDREW FARDIN JAZBANI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPT
Contact information
Practice address
5605 100TH ST SW STE B, LAKEWOOD, WA 98499-2710
(253) 284-9800
(253) 284-9801
Mailing address
2001 BUTTERFIELD RD STE 1600, DOWNERS GROVE, IL 60515-1211
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
2022043936
MO
225100000X
Physical Therapist
Primary
—
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2022043936
PHYSICAL THERAPY LICENSE NUMBER
MO
Enumeration date
11/04/2022
Last updated
08/05/2025
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