Provider Demographics
NPI:1316316656
Name:BIRCHFIELD, JENNA CATRAELL
Entity type:Individual
Prefix:
First Name:JENNA
Middle Name:CATRAELL
Last Name:BIRCHFIELD
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:701 5TH AVE
Mailing Address - Street 2:STE 213
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98104-7097
Mailing Address - Country:US
Mailing Address - Phone:206-682-3122
Mailing Address - Fax:
Practice Address - Street 1:701 5TH AVE
Practice Address - Street 2:STE 213
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98104-7097
Practice Address - Country:US
Practice Address - Phone:206-682-3122
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-09-16
Last Update Date:2015-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAP160592333225200000X
CA10974225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant