Birgit Jennifer Broadstone, PT

Primary specialty

Pediatric Physical TherapistTaxonomy code 2251P0200X

License

00003582 Issued in WA

Practice address

17077 Meridian Ave N
Shoreline, WA 98133-5531

Phone

(206) 393-1704

Fax

(206) 393-1787

NPI assigned

Sep 18, 2012

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

Other names 1

• Jennifer L Broadstone Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1347926400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1347926400000",
    "number": "1669722617",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17077 MERIDIAN AVE N",
            "city": "SHORELINE",
            "state": "WA",
            "postal_code": "981335531",
            "telephone_number": "206-393-1704",
            "fax_number": "206-393-1787"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17077 MERIDIAN AVE N",
            "city": "SHORELINE",
            "state": "WA",
            "postal_code": "981335531",
            "telephone_number": "206-393-1704",
            "fax_number": "206-393-1787"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROADSTONE",
        "first_name": "BIRGIT",
        "middle_name": "JENNIFER",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-09-18",
        "last_updated": "2012-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251P0200X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Pediatrics",
            "state": "WA",
            "license": "00003582",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENNIFER",
            "last_name": "BROADSTONE",
            "middle_name": "L",
            "credential": "PT",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Jesse J Boyett, DDS, PLLC
• Matthew Kegan Branaman, L.M.P
• Jordan M Brenner, D.D.S.
• Nicole Bride
• Katherine Brittain
• Kate Brockhaus, LMHCA
• Emily Brothers, RN
• David Loren Broweleit, D.D.S., M.S.D.
• Alva Phillip Brower, L.M.P.
• Bridget Ann Brown

• Pediatric Physical Therapist in Shoreline, WA
• Providers in Shoreline, WA by specialty
• Pediatric Physical Therapist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2012; 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.