Individual provider Active NPI

Jacob Ferry

  • Physical Therapist
  • Woodinville, WA
National Provider Identifier
1497620587
Registry record updated Oct 8, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT70032618 Issued in WA
Practice address
17500 133Rd Ave NE
Suite a
Woodinville, WA 98072-3609
Phone
(425) 286-6615
Fax
(425) 286-6649
NPI assigned
Oct 8, 2025
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 8, 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 PT70032618 WA Primary

Addresses

Primary practice location

17500 133Rd Ave NE
Suite a
Woodinville, WA 98072-3609

Mailing address

209 Kirkland Ave
Kirkland, WA 98033-6503

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20251023001760 WA Practitioner - Physical Therapist in Private Practice 5991293706 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lake Washington Physical Therapy LLCGroup PAC ID 3476679812, 54 clinicians

Practice addresses (Care Compare)

17500 133Rd Ave NE
Suite a
Woodinville, WA 98072-3609
Phone (425) 286-6615

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT70032618WAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Lake Washington Physical Therapy LLC Physical Therapist CurrentSince Oct 13, 2025 Accepting new patients

Locations

209 Kirkland Ave
Kirkland, WA 98033
Phone (425) 629-3502

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.

NPI Registry JSON

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

{
    "created_epoch": "1759881600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1759881600000",
    "number": "1497620587",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "209 KIRKLAND AVE",
            "city": "KIRKLAND",
            "state": "WA",
            "postal_code": "980336503"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17500 133RD AVE NE",
            "address_2": "SUITE A",
            "city": "WOODINVILLE",
            "state": "WA",
            "postal_code": "980723609",
            "telephone_number": "425-286-6615",
            "fax_number": "425-286-6649"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FERRY",
        "first_name": "JACOB",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-10-08",
        "last_updated": "2025-10-08",
        "certification_date": "2025-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WA",
            "license": "PT70032618",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Woodinville, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 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.