Individual provider Active NPI

Jesse Randy Pangelinan, DPT, PT

  • Physical Therapist
  • Kirkland, WA
National Provider Identifier
1104732478
Registry record updated Aug 28, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT.PT.70143480 Issued in WA
Practice address
947 6TH St S
Kirkland, WA 98033-6712
Phone
(425) 823-1389
Fax
(425) 820-3996
NPI assigned
Aug 19, 2026
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 28, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT.PT.70143480 WA Primary

Addresses

Primary practice location

947 6TH St S
Kirkland, WA 98033-6712

Mailing address

1300 W Sam Houston Pkwy S Ste 300
Houston, TX 77042-2453
Phone (425) 823-1389

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

NPI Registry JSON

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

{
    "created_epoch": "1787097600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787875200000",
    "number": "1104732478",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1300 W SAM HOUSTON PKWY S STE 300",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770422453",
            "telephone_number": "425-823-1389",
            "fax_number": "425-820-3996"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "947 6TH ST S",
            "city": "KIRKLAND",
            "state": "WA",
            "postal_code": "980336712",
            "telephone_number": "425-823-1389",
            "fax_number": "425-820-3996"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PANGELINAN",
        "first_name": "JESSE",
        "middle_name": "RANDY",
        "credential": "DPT, PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2026-08-19",
        "last_updated": "2026-08-28",
        "certification_date": "2026-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WA",
            "license": "PT.PT.70143480",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kirkland, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2026; 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.