Individual provider Active NPI

Jennifer C Wallerich, DPT

  • Physical Therapist
  • Seattle, WA
National Provider Identifier
1205922796
Registry record updated Sep 10, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT00010218 Issued in WA
Practice address
925 8TH Ave N
Seattle, WA 98109-6304
Phone
(206) 631-2818
Fax
(206) 631-2819
NPI assigned
Oct 4, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 10, 2014

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 PT00010218 WA Primary

Addresses

Primary practice location

925 8TH Ave N
Seattle, WA 98109-6304

Mailing address

925 8TH Ave N
Seattle, WA 98109-6304
Phone (206) 631-2818

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20061114000439 WA Practitioner - Physical Therapist in Private Practice 6002814688 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Washington Luna Care Physical Therapy LLCGroup PAC ID 7416283817, 161 clinicians

Practice addresses (Care Compare)

Bellevue, WA 98006
Phone (866) 525-3175

Merit-based Incentive Payment System (MIPS)

Final score
85.56 of 100Reported as group
Quality
89.84
Improvement activities
40
Cost
70.51

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT00010218WAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
North Peninsula Physical Therapy, PLLC CurrentSince Jan 4, 2020 Accepting new patients
Swedish Health Services CurrentSince Sep 9, 2024 Accepting new patients
King County Public Hospital District No. 2 Physical Therapist CurrentSince Jun 19, 2024 Accepting new patients
King County Public Hospital District No 2 Current Accepting new patients
Swedish Health Services Physical Therapist CurrentSince Sep 9, 2024 Accepting new patients
Washington Luna Care Physical Therapy LLC Physical Therapist CurrentSince Jun 19, 2024 Accepting new patients

Locations

13555 SE 36th St
Ste 100
Bellevue, WA 98006

13020 Meridian Ave S
Everett, WA 98208
Phone (425) 357-3700

12040 NE 128th St
#10
Kirkland, WA 98034
Phone (206) 466-0369

19980 10th Ave NE
Ste 201
Poulsbo, WA 98370
Phone (360) 598-1538

800 5th Ave
Ste P100
Seattle, WA 98104
Phone (206) 320-2700

2450 33rd Ave W
Ste 100
Seattle, WA 98199
Phone (206) 320-3364

1959 NE Pacific St
Seattle, WA 98195
Phone (206) 598-4333

111 Tumwater Blvd SE
Ste 113
Tumwater, WA 98501
Phone (360) 528-3300

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1159920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1410307200000",
    "number": "1205922796",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "925 8TH AVE N",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981096304",
            "telephone_number": "206-631-2818",
            "fax_number": "206-631-2819"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "925 8TH AVE N",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981096304",
            "telephone_number": "206-631-2818",
            "fax_number": "206-631-2819"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALLERICH",
        "first_name": "JENNIFER",
        "middle_name": "C",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-04",
        "last_updated": "2014-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WA",
            "license": "PT00010218",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Seattle, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.