Jacob Christopher Burggraff, PT, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT61335329 Issued in WA

Practice address

7409 NE Hazel Dell Ave Ste 112
Vancouver, WA 98665-8337

Phone

(360) 597-4048

NPI assigned

Sep 6, 2022

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Prism Pediatric Therapy Associates PLLC

  • Pediatric Physical Therapist
  • Vancouver, WA
  • NPI 1336506823
  NPD (past)
• Speech and Occupational Specialists, LLC

  • Clinic/Center
  • Winter Garden, FL
  • NPI 1215288667
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1662422400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1677628800000",
    "number": "1003537416",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1940 S BONITO WAY STE 190",
            "city": "MERIDIAN",
            "state": "ID",
            "postal_code": "836425618",
            "telephone_number": "208-287-9420"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7409 NE HAZEL DELL AVE STE 112",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986658337",
            "telephone_number": "360-597-4048"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURGGRAFF",
        "first_name": "JACOB",
        "middle_name": "CHRISTOPHER",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-09-06",
        "last_updated": "2023-03-01",
        "certification_date": "2023-03-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WA",
            "license": "PT61335329",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Charles Burgamy Jr.
• Makayla Burger
• David Burgers
• Finneas Omen Burgess, LMT
• Alisa Burggrabe-Brossia, LMP
• Taylor Burggraff
• Julia Burgoyne, LICSWA
• Connie Lynn Burgstahler
• Kimberly Burk
• Christopher Burke, MD

• Physical Therapist in Vancouver, WA
• Providers in Vancouver, WA by specialty
• Physical Therapist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 1, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.