Provider Demographics
NPI:1215711429
Name:MAGADIA, JOBELLE ANNE FELICITAS (DPT)
Entity type:Individual
Prefix:
First Name:JOBELLE ANNE
Middle Name:FELICITAS
Last Name:MAGADIA
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:JOBELLE ANNE
Other - Middle Name:
Other - Last Name:DUARTE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPT
Mailing Address - Street 1:6050 TACOMA MALL BLVD STE 300
Mailing Address - Street 2:
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98409-6828
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:8011 112TH STREET CT E
Practice Address - Street 2:
Practice Address - City:PUYALLUP
Practice Address - State:WA
Practice Address - Zip Code:98373-7814
Practice Address - Country:US
Practice Address - Phone:253-848-0662
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-21
Last Update Date:2023-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPT61112650225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist