Provider Demographics
NPI:1053173351
Name:SCOTT, JEFFERY JR (PT, DPT)
Entity type:Individual
Prefix:DR
First Name:JEFFERY
Middle Name:
Last Name:SCOTT
Suffix:JR
Gender:M
Credentials:PT, DPT
Other - Prefix:
Other - First Name:JEFF
Other - Middle Name:
Other - Last Name:SCOTT
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:12040 NE 128TH ST # MS 103
Mailing Address - Street 2:
Mailing Address - City:KIRKLAND
Mailing Address - State:WA
Mailing Address - Zip Code:98034-3013
Mailing Address - Country:US
Mailing Address - Phone:425-866-6519
Mailing Address - Fax:
Practice Address - Street 1:12040 NE 128TH ST # MS 103
Practice Address - Street 2:
Practice Address - City:KIRKLAND
Practice Address - State:WA
Practice Address - Zip Code:98034-3013
Practice Address - Country:US
Practice Address - Phone:425-866-6519
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-01-23
Last Update Date:2024-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPT60531533225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist