Individual provider Active NPI

Jessica M. Liberty, DPT

  • Physical Therapist
  • Issaquah, WA
National Provider Identifier
1356689335
Registry record updated May 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT61577951 Issued in MA
Practice address
510 8TH Ave NE Ste 340
Issaquah, WA 98029-5449
Phone
(425) 313-3055
Fax
(425) 313-3051
NPI assigned
Jan 25, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 16, 2025

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 PT61577951 MA Primary

Addresses

Primary practice location

510 8TH Ave NE Ste 340
Issaquah, WA 98029-5449

Mailing address

510 8TH Ave NE Ste 320
Issaquah, WA 98029-5436
Phone (425) 313-3055

Other practice location 1

1200 112th Ave NE Ste C260
Bellevue, WA 98004-3746
Phone (425) 313-3055

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA, AK, WA3 enrollments

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20130506000372 MA Practitioner - Physical Therapist in Private Practice 3173760410 Reassigns benefits to 2 organizations
I20240607001189 AK Practitioner - Physical Therapist in Private Practice 3173760410 Reassigns benefits to 1 organization
I20250604003400 WA Practitioner - Physical Therapist in Private Practice 3173760410 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Proliance Surgeons Inc P SGroup PAC ID 8527972900, 395 clinicians

Practice addresses (Care Compare)

510 8TH Ave NE
Suite 340
Issaquah, WA 98029-5449
Phone (425) 313-3055

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT61577951MAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Proliance Surgeons, Inc., P.S. Physical Therapist CurrentSince May 12, 2025 Accepting new patients
Proex Physical Therapy, LLC Physical Therapist CurrentSince Jan 2, 2018 Accepting new patients
Proex Physical Therapy, LLC CurrentSince Jan 2, 2018 Accepting new patients
Bay State Physical Therapy of Randolph Inc Physical Therapist CurrentSince Feb 17, 2013 Accepting new patients
Proliance Surgeons Inc P S Current Accepting new patients
Proliance Surgeons Inc P S CurrentSince May 12, 2025 Accepting new patients
Advanced Physical Therapy Inc Physical Therapist CurrentSince May 22, 2024 Accepting new patients
Pioneer Peak Orthopedics LLC Past Accepting new patients

Locations

1917 Abbott Rd
Ste 200
Anchorage, AK 99507
Phone (907) 279-4266

44604 Sterling Hwy
Ste A
Soldotna, AK 99669
Phone (907) 420-0640

607 Boylston St
Fl 4
Boston, MA 02116
Phone (857) 240-0909

10 High St
Ste 303
Boston, MA 02110
Phone (617) 542-6999

703 Granite St
Ste 3
Braintree, MA 02184

1 Pearl St
Ste 1700
Brockton, MA 02301
Phone (508) 427-0525

284 Monponsett St
Ste 102
Halifax, MA 02338
Phone (781) 293-2525

1343 Providence Hwy
Norwood, MA 02062
Phone (781) 702-1339

1 Credit Union Way
Fl 3
Randolph, MA 02368
Phone 7819613370225

425 Waverly Oaks Rd
Waltham, MA 02452
Phone (781) 373-3620

300 Tradecenter
Ste 1650
Woburn, MA 01801
Phone (781) 925-7643

576 Broadhollow Rd
Melville, NY 11747

1200 112th Ave NE
Ste C260
Bellevue, WA 98004
Phone (425) 313-3055

510 8th Ave NE
Ste 320
Issaquah, WA 98029

510 8th Ave NE
Ste 340
Issaquah, WA 98029
Phone (425) 313-3051

805 Madison St
Ste 901
Seattle, WA 98104
Phone (206) 264-8100

Interoperability endpoints

  • FHIR API: https://fhir.meditouchehr.com/api/fhir/r4/

Organizations & group practices 8

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": "1359072000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747353600000",
    "number": "1356689335",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "510 8TH AVE NE STE 320",
            "city": "ISSAQUAH",
            "state": "WA",
            "postal_code": "980295436",
            "telephone_number": "425-313-3055",
            "fax_number": "425-313-3051"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "510 8TH AVE NE STE 340",
            "city": "ISSAQUAH",
            "state": "WA",
            "postal_code": "980295449",
            "telephone_number": "425-313-3055",
            "fax_number": "425-313-3051"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1200 112th Ave NE Ste C260",
            "address_purpose": "LOCATION",
            "city": "Bellevue",
            "state": "WA",
            "postal_code": "980043746",
            "country_code": "US",
            "telephone_number": "425-313-3055",
            "fax_number": "425-313-3051",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LIBERTY",
        "first_name": "JESSICA",
        "middle_name": "M.",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-01-25",
        "last_updated": "2025-05-16",
        "certification_date": "2025-05-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MA",
            "license": "PT61577951",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Issaquah, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 2025; 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.