Jessica Costello

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

P1 60235544 Issued in WA

Practice address

800 N Medcalf LN
Montesano, WA 98563-1318

Phone

(360) 249-2273

Fax

(360) 249-2363

NPI assigned

Sep 17, 2015

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

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": "1442448000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1442448000000",
    "number": "1922477116",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 N MEDCALF LN",
            "city": "MONTESANO",
            "state": "WA",
            "postal_code": "985631318",
            "telephone_number": "360-249-2273",
            "fax_number": "360-249-2363"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 N MEDCALF LN",
            "city": "MONTESANO",
            "state": "WA",
            "postal_code": "985631318",
            "telephone_number": "360-249-2273",
            "fax_number": "360-249-2363"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COSTELLO",
        "first_name": "JESSICA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-09-17",
        "last_updated": "2015-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "WA",
            "license": "P1 60235544",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Susan Marie Clark, M. ED.
• Brooke Colburn
• Connections, a Center for Healthy Families
• Connections, a Center for Healthy Families
• Core Chiropractic Clinic, P.S.
• Aaron L Criner, CPC
• Sandra Custer
• Kristin Maureen Cutler, SLP
• Renee Dawn Lacasse Dagnen, L.M.T.
• Amanda Deangelo, DROT

• Physical Therapy Assistant in Montesano, WA
• Providers in Montesano, WA by specialty
• Physical Therapy Assistant in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2015; 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.