Jacob Stickell, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

61187238 Issued in WA

Practice address

322 W North River Dr
Spokane, WA 99201-3208

Phone

(509) 324-6464

Fax

(509) 241-2056

NPI assigned

Oct 20, 2021

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Northwest Center for Sports Medicine & Physical Therapy, Inc.

  • Physical Therapist
  • Gig Harbor, WA
  • NPI 1982755070
  NPD
• Northwest Center for Sports Medicine & Physical Therapy, Inc.

  • Physical Therapist
  • Tacoma, WA
  • NPI 1225582844
  NPD (past)

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

{
    "created_epoch": "1634688000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666915200000",
    "number": "1225791718",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25013 67TH AVE E",
            "city": "GRAHAM",
            "state": "WA",
            "postal_code": "983389560",
            "telephone_number": "253-232-2407"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "322 W NORTH RIVER DR",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992013208",
            "telephone_number": "509-324-6464",
            "fax_number": "509-241-2056"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1745 Pike Ave",
            "address_purpose": "LOCATION",
            "city": "Richland",
            "state": "WA",
            "postal_code": "993542295",
            "country_code": "US",
            "telephone_number": "509-946-8095",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STICKELL",
        "first_name": "JACOB",
        "name_prefix": "Dr.",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-10-20",
        "last_updated": "2022-10-28",
        "certification_date": "2022-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WA",
            "license": "61187238",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwa.kp.org:14430/Interconnect-CE-PRD/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ceq",
            "affiliation": "N",
            "endpointDescription": "Carequality",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "322 W North River Dr",
            "city": "Spokane",
            "state": "WA",
            "country_code": "US",
            "postal_code": "992013208",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Michael Stewart, D.O.
• Olena Stewart, CRNA
• Robert James Stewart, M.D.
• Sarah Ann Stewart, ARNP
• Stormy Stewart, ARNP
• Cara Marie Stickelmeyer, CBT
• Miranda Renee Stieber, LMT
• John Stifter, LMHC, LMFTA
• Heather Stiles
• Michelle Stiles, PA-C

• Physical Therapist in Spokane, WA
• Providers in Spokane, WA by specialty
• Physical Therapist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2022; 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.