Active NPI
Jeneca Lea Thomas, DPT
- Physical Therapist
- Lake Stevens, WA
National Provider Identifier
1124406558
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- Practice address
- 402 91St Ave NE
Lake Stevens, WA 98258-2530 - Phone
- (425) 261-9827
- NPI assigned
- May 18, 2015
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | Primary |
Addresses
Primary practice location
402 91St Ave NE
Lake Stevens, WA 98258-2530
Mailing address
17403 43Rd Dr NW
Stanwood, WA 98292-7993
Phone (425) 923-4496
Other practice location 1
6040 SE Belmont St
Portland, OR 97215-1974
Phone (503) 231-7166
Other names 1
- Jeneca Lea Hoidal
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": "1431907200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1613001600000",
"number": "1124406558",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "17403 43RD DR NW",
"city": "STANWOOD",
"state": "WA",
"postal_code": "982927993",
"telephone_number": "425-923-4496"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "402 91ST AVE NE",
"city": "LAKE STEVENS",
"state": "WA",
"postal_code": "982582530",
"telephone_number": "425-261-9827"
}
],
"practiceLocations": [
{
"address_1": "6040 SE Belmont St",
"address_purpose": "LOCATION",
"city": "Portland",
"state": "OR",
"postal_code": "972151974",
"country_code": "US",
"telephone_number": "503-231-7166",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "THOMAS",
"first_name": "JENECA",
"middle_name": "LEA",
"credential": "DPT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-05-18",
"last_updated": "2021-02-11",
"certification_date": "2021-02-11",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "JENECA",
"last_name": "HOIDAL",
"middle_name": "LEA",
"code": "1",
"type": "Former Name"
}
]
}
Other providers in Lake Stevens, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.