Provider Demographics
NPI:1891860318
Name:GHENT, JILL TOMLINSON (DPT)
Entity type:Individual
Prefix:
First Name:JILL
Middle Name:TOMLINSON
Last Name:GHENT
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:JILL
Other - Middle Name:
Other - Last Name:TOMLINSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPT
Mailing Address - Street 1:10550 HARBOR HILL DR NW
Mailing Address - Street 2:
Mailing Address - City:GIG HARBOR
Mailing Address - State:WA
Mailing Address - Zip Code:98332-8944
Mailing Address - Country:US
Mailing Address - Phone:253-530-8970
Mailing Address - Fax:253-858-1143
Practice Address - Street 1:10550 HARBOR HILL DR NW
Practice Address - Street 2:
Practice Address - City:GIG HARBOR
Practice Address - State:WA
Practice Address - Zip Code:98332-8944
Practice Address - Country:US
Practice Address - Phone:253-530-8970
Practice Address - Fax:253-858-1143
Is Sole Proprietor?:No
Enumeration Date:2006-11-21
Last Update Date:2014-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPT00008901225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA6712TOOtherREGENCE BCBS GIG HARBOR
WA1112TOOtherREGENCE BCBS TACOMA
WA188058OtherLABOR AND INDUSTRIES WC
WA650024855OtherRR MEDICARE
WA8424731Medicaid
WA6712TOOtherREGENCE BCBS GIG HARBOR