Jake Ryan Allstot, PTA

Individual provider Active NPI Physical Therapy Assistant · Spokane Valley, WA

NPI 1376748152 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1376748152
Entity type
Individual (NPI type 1)
Primary specialty
Physical Therapy Assistant 225200000X
License
PTA-2143 (ID)
Practice address
601 S Park Rd Ste 1
Spokane Valley, WA 99212-4517
Phone
(509) 921-7818
NPI assigned
Jun 20, 2007
Sex
Male
Sole proprietor
Yes

Organizations & group practices 1

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.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
PTA-2143IDMDPhysical Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Northwest Therapy Resources, P.S. Physical Therapy Assistant Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X PTA-2143 ID Yes

Addresses

Primary practice location

601 S Park Rd Ste 1
Spokane Valley, WA 99212-4517

Mailing address

715 S Lincoln St Apt 202S
Spokane, WA 99204-2936
Phone (509) 869-8741

Other providers in Spokane Valley, WA

All providers in Spokane Valley, WA · Physical Therapy Assistant in Washington

Sources for this page

Verify at the official NPI Registry.