Individual provider Active NPI

Destini Coney Jammeh, PTA

  • Physical Therapy Assistant
  • Auburn, WA
National Provider Identifier
1245472760
Registry record updated Mar 30, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
P160029218 Issued in WA
Practice address
414 17TH St SE
Auburn, WA 98002-6822
Phone
(253) 876-7235
NPI assigned
Mar 30, 2009
Last updated
Mar 30, 2009By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 30, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X P160029218 WA Primary

Addresses

Primary practice location

414 17TH St SE
Auburn, WA 98002-6822

Mailing address

23309 61St Ave S Apt Ee202
Kent, WA 98032-4831
Phone (325) 232-0835

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

State licenses

LicenseStateTypeSpecialty
P160029218WAMDPhysical Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1238371200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1238371200000",
    "number": "1245472760",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23309 61ST AVE S APT EE202",
            "city": "KENT",
            "state": "WA",
            "postal_code": "980324831",
            "telephone_number": "325-232-0835"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "414 17TH ST SE",
            "city": "AUBURN",
            "state": "WA",
            "postal_code": "980026822",
            "telephone_number": "253-876-7235"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JAMMEH",
        "first_name": "DESTINI",
        "middle_name": "CONEY",
        "name_prefix": "Mrs.",
        "credential": "PTA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-03-30",
        "last_updated": "2009-03-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "WA",
            "license": "P160029218",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Auburn, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2009; 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.