Individual provider Active NPI

Jolyn Janea Liquido, PTA

  • Physical Therapy Assistant
  • Tacoma, WA
National Provider Identifier
1023569860
Registry record updated Sep 26, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
P1 60665891 Issued in WA
Practice address
1313 Broadway Ste 200
Tacoma, WA 98402-3400
Phone
(253) 318-8755
NPI assigned
Oct 17, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 26, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X P1 60665891 WA Primary

Addresses

Primary practice location

1313 Broadway Ste 200
Tacoma, WA 98402-3400

Mailing address

1600 Benson Rd S Apt 304
Renton, WA 98055-4540
Phone (253) 397-8214

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
P1 60665891WAMDPhysical Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1476662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695686400000",
    "number": "1023569860",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1600 BENSON RD S APT 304",
            "city": "RENTON",
            "state": "WA",
            "postal_code": "980554540",
            "telephone_number": "253-397-8214"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1313 BROADWAY STE 200",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984023400",
            "telephone_number": "253-318-8755"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIQUIDO",
        "first_name": "JOLYN",
        "middle_name": "JANEA",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-10-17",
        "last_updated": "2023-09-26",
        "certification_date": "2023-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "WA",
            "license": "P1 60665891",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tacoma, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 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.