Provider Demographics
NPI:1528272374
Name:NEPHEW, JAIME RAE (PT, DPT)
Entity type:Individual
Prefix:
First Name:JAIME
Middle Name:RAE
Last Name:NEPHEW
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2100 LAKE WASHINGTON BLVD N
Mailing Address - Street 2:UNIT L-103
Mailing Address - City:RENTON
Mailing Address - State:WA
Mailing Address - Zip Code:98056-1449
Mailing Address - Country:US
Mailing Address - Phone:956-337-6299
Mailing Address - Fax:425-656-5419
Practice Address - Street 1:2100 LAKE WASHINGTON BLVD N
Practice Address - Street 2:UNIT L-103
Practice Address - City:RENTON
Practice Address - State:WA
Practice Address - Zip Code:98056-1449
Practice Address - Country:US
Practice Address - Phone:956-337-6299
Practice Address - Fax:425-656-5419
Is Sole Proprietor?:No
Enumeration Date:2007-05-10
Last Update Date:2010-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPT60129132225100000X
TX1148367225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist