Janie E Ackerman
Individual provider Active NPI Physical Therapist · Laconner, WA
NPI 1083633994 · NPPES record last updated Jul 9, 2007
Key facts
- NPI
- 1083633994
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapist 225100000X
- License
- PT00006228 (WA)
- Practice address
- 413 Morris St
Laconner, WA 98257 - Phone
- (360) 466-7458
- Fax
- (360) 466-1418
- NPI assigned
- Jul 19, 2006
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| La Conner Health and Wellness LLC | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | PT00006228 | WA | Yes |
Addresses
Primary practice location
413 Morris St
Laconner, WA 98257
Mailing address
PO Box 505
413 Morris St
La Conner, WA 98257-0505
Phone (360) 466-7458
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 8385296 | Medicaid | WA |
Other providers in Laconner, WA
All providers in Laconner, WA · Physical Therapist in Washington
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 9, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.