Individual
JEANNE A DIRKSEN
Active
Individual
JEANNE A DIRKSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT00002165
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5812580
AETNA
WA
01
—
6147DI
REGENCE BLUE SHIELD
WA
05
—
8374688
—
WA
01
—
A002
TRICARE WEST
WA
01
—
G8862188
MEDICARE GROUP
WA
01
—
P00408657
RAILROAD MEDICARE PTAN
—
Enumeration date
07/18/2006
Last updated
04/14/2008
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