Individual
MR. JON ROGER LUEBKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
10505 19TH AVE SE, SUITE B, EVERETT, WA 98208-4280
(408) 570-0510
(408) 945-4018
Mailing address
3726 BROADWAY, #104, EVERETT, WA 98201-3787
(425) 252-4600
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT 00002958
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0009LU
REGENCE
WA
01
—
0010LU
REGENCE
WA
01
—
0011LU
REGENCE
WA
01
—
0012LU
REGENCE
WA
01
—
0013LU
REGENCE
WA
01
—
0014LU
REGENCE
WA
01
—
0023LU
REGENCE
WA
01
—
0033LU
REGENCE
WA
01
—
0190810
LABOR AND INDUSTRIES
WA
01
—
0258191
L&I
WA
01
—
0258768
L&I
WA
01
—
0258807
L&I
WA
01
—
9141LU
REGENCE
WA
01
—
P00893797
RAILROAD MEDICARE
WA
Enumeration date
01/11/2007
Last updated
01/28/2013
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