Deanna R Jannush

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

160.002219 Issued in IL

Practice address

25117 SW Parkway Ave Ste D
Wilsonville, OR 97070-9697

Phone

(971) 224-2040

NPI assigned

May 10, 2018

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Deanna R Dutter Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1525910400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1525910400000",
    "number": "1245720796",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19834 S EDINBURGH LN",
            "city": "FRANKFORT",
            "state": "IL",
            "postal_code": "604236922",
            "telephone_number": "708-903-2226"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25117 SW PARKWAY AVE STE D",
            "city": "WILSONVILLE",
            "state": "OR",
            "postal_code": "970709697",
            "telephone_number": "971-224-2040"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JANNUSH",
        "first_name": "DEANNA",
        "middle_name": "R",
        "name_prefix": "Ms.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-05-10",
        "last_updated": "2018-05-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "IL",
            "license": "160.002219",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DEANNA",
            "last_name": "DUTTER",
            "middle_name": "R",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Danielle Fernanda Jackovitz, M.S.
• Jason Russell James, P.T., D.P.T.
• Lauryl James, PT
• Renee L. James, MPT
• Nancy Jameson
• Yelizaveta Jarding
• C Susan Jardon
• Jesse Achatz DMD LLC
• Christine Johnson
• Kelli M Johnson, OT

• Physical Therapy Assistant in Wilsonville, OR
• Providers in Wilsonville, OR by specialty
• Physical Therapy Assistant in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 10, 2018; 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.