Jeannine Poucel Mackie, MPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT00008252 Issued in WA

Practice address

4545 Point Fosdick Dr NW
Gig Harbor, WA 98335-1700

Phone

(253) 792-6555

NPI assigned

Oct 16, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in WA

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Hanson and Purdue Physical Therapy Inc PS

  dba Grant Spangle Physical Therapy

  • Physical Therapist
  • Gig Harbor, WA
  • NPI 1710226188
  Medicare reassignment NPD
• Kaiser Foundation Health Plan of Washington

  • Multi-Specialty Clinic/Center
  • Seattle, WA
  • NPI 1396810701
  Medicare reassignment NPD
• Multicare Health System

  dba Multicare Neurological Surgery

  • Neurological Surgery Physician
  • Tacoma, WA
  • NPI 1497766638
  Medicare reassignment NPD
• Kaiser Foundation Health Plan of Washington

  dba Everett Medical Center

  • Multi-Specialty Clinic/Center
  • Everett, WA
  • NPI 1386935351
  NPD
• Multicare Health System

  dba MultiCare Deaconess Retail Pharmacy

  • Community/Retail Pharmacy
  • Spokane, WA
  • NPI 1396594875
  NPD
• Multicare Health System

  dba MultiCare Behavioral Health

  • Community/Behavioral Health Agency
  • Auburn, WA
  • NPI 1861872178
  NPD
• Peak Sports & Spine Physical Therapy-Renton, P.S.

  • Physical Therapist
  • Renton, WA
  • NPI 1841388618
  NPD (past)
• Sound Physical Therapy

  • Clinic/Center
  • Seattle, WA
  • NPI 1487786448
  NPD (past)

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

{
    "created_epoch": "1192492800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1648684800000",
    "number": "1619166550",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "315 MARTIN LUTHER KING JR WAY",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984054234"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4545 POINT FOSDICK DR NW",
            "city": "GIG HARBOR",
            "state": "WA",
            "postal_code": "983351700",
            "telephone_number": "253-792-6555"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3823 Delridge Way SW",
            "address_purpose": "LOCATION",
            "city": "Seattle",
            "state": "WA",
            "postal_code": "981061133",
            "country_code": "US",
            "telephone_number": "206-301-0600",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MACKIE",
        "first_name": "JEANNINE",
        "middle_name": "POUCEL",
        "credential": "MPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-10-16",
        "last_updated": "2022-03-31",
        "certification_date": "2022-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WA",
            "license": "PT00008252",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwa.kp.org:14430/Interconnect-CE-PRD/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ceq",
            "affiliation": "N",
            "endpointDescription": "Carequality",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "3823 Delridge Way SW",
            "city": "Seattle",
            "state": "WA",
            "country_code": "US",
            "postal_code": "981061133",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Corinne Lynn, MA CCC SLP
• Jennifer RM Lyons, RDH
• Andrew A Ma, DO
• Katherine Bouglai Macdonald
• Linda Jean Macdonald, LMFT
• Tyler Madison
• Susane Magnani, LMP
• Amy Louise Maher, MD
• Jacqueline Ann Mahre-Murphy, PT
• Teresa Kay Maib, LCSW

• Physical Therapist in Gig Harbor, WA
• Providers in Gig Harbor, WA by specialty
• Physical Therapist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.