Active NPI
Jarron Mitchell
- Physical Therapist
- Selah, WA
National Provider Identifier
1205064193
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT60091500
- Practice address
- 117 S 2ND St
Selah, WA 98942-1307 - Phone
- (509) 697-9109
- Fax
- (509) 697-9122
- NPI assigned
- Jun 30, 2009
- Sex
- Male
- 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 | PT60091500 | WA | Primary |
Addresses
Primary practice location
117 S 2ND St
Selah, WA 98942-1307
Mailing address
16083 SW Upper Boones Ferry Rd
Suite 300
Tigard, OR 97224-7736
Phone (800) 219-8835
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| P01322183 | Other | WA | RR |
| 1205064193 | Medicaid | WA |
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PT60091500 | WA | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Therapeutic Associates Inc | Physical Therapist | Past | Accepting new patients |
| Therapeutic Associates Inc | Physical Therapist | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba TAI Cedar Hills Physical Therapy
- Physical Therapist
- Portland, OR
- NPI 1700862000
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1246320000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1406592000000",
"number": "1205064193",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "16083 SW UPPER BOONES FERRY RD",
"address_2": "SUITE 300",
"city": "TIGARD",
"state": "OR",
"postal_code": "972247736",
"telephone_number": "800-219-8835",
"fax_number": "503-693-9699"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "117 S 2ND ST",
"city": "SELAH",
"state": "WA",
"postal_code": "989421307",
"telephone_number": "509-697-9109",
"fax_number": "509-697-9122"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MITCHELL",
"first_name": "JARRON",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2009-06-30",
"last_updated": "2014-07-29",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "WA",
"license": "PT60091500",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RR",
"identifier": "P01322183",
"state": "WA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1205064193",
"state": "WA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Selah, WA
- Memorial Physicians, P.L.L.C. (Selah Family Medicine)
- Memorial Practice Management, LLC (Selah Family Medicine)
- Michael McKay DDS PLLC (Selah Smiles)
- Amy Laurel Miller, PA-C
- Megan Miller
- Shirley Mohren-Graves, ARNP
- Saley Karim Molina
- Lisa Leah Moore, CDP
- Erin L Morris, PT
- Mower Vision Source, PLLC (Selah Vision Clinic)
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.