Individual provider Active NPI

Ma. Michelle Jayobo, BS

  • Physical Therapist
  • Shelton, WA
National Provider Identifier
1669708434
Registry record updated Oct 28, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT60106716 Issued in WA
Practice address
2430 N 13TH St
Shelton, WA 98584-1213
Phone
(360) 426-1651
NPI assigned
Oct 28, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 28, 2009

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 PT60106716 WA Primary

Addresses

Primary practice location

2430 N 13TH St
Shelton, WA 98584-1213

Mailing address

3290 N Ridge Rd Ste 290
Ellicott City, MD 21043-3657
Phone (410) 750-9006

Medicare participation

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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Bachelor of Science

State licenses

LicenseStateTypeSpecialty
PT60106716WAMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1256688000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1256688000000",
    "number": "1669708434",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3290 N RIDGE RD STE 290",
            "city": "ELLICOTT CITY",
            "state": "MD",
            "postal_code": "210433657",
            "telephone_number": "410-750-9006",
            "fax_number": "410-750-0787"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2430 N 13TH ST",
            "city": "SHELTON",
            "state": "WA",
            "postal_code": "985841213",
            "telephone_number": "360-426-1651"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JAYOBO",
        "first_name": "MA. MICHELLE",
        "credential": "BS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-10-28",
        "last_updated": "2009-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WA",
            "license": "PT60106716",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Shelton, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2009; 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.