Provider Demographics
NPI:1992083927
Name:FLENTKE, JENNIFER JEANNE (PT)
Entity type:Individual
Prefix:MS
First Name:JENNIFER
Middle Name:JEANNE
Last Name:FLENTKE
Suffix:
Gender:
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18414 NE GARDEN DR
Mailing Address - Street 2:
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98682-3612
Mailing Address - Country:US
Mailing Address - Phone:503-810-0837
Mailing Address - Fax:
Practice Address - Street 1:18414 NE GARDEN DR
Practice Address - Street 2:
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98682-3612
Practice Address - Country:US
Practice Address - Phone:503-810-0837
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-25
Last Update Date:2025-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR3303225100000X
WAPT 00009414225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist