Active NPI
Jennifer Krista Stewart, PTA
- Physical Therapy Assistant
- Everett, WA
National Provider Identifier
1922861962
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- 60340820
- Practice address
- 2431 Broadway
Everett, WA 98201-3018 - Phone
- (425) 252-4600
- NPI assigned
- Feb 2, 2024
- Last updated
- Feb 7, 2024
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapy Assistant | 225200000X | 60340820 | WA | Primary |
Addresses
Primary practice location
2431 Broadway
Everett, WA 98201-3018
Mailing address
11320 N Lakeshore Dr
Lake Stevens, WA 98258-9418
Phone (415) 652-7885
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 60340820 | WA | MD | Physical Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1706832000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1707264000000",
"number": "1922861962",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11320 N LAKESHORE DR",
"city": "LAKE STEVENS",
"state": "WA",
"postal_code": "982589418",
"telephone_number": "415-652-7885"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2431 BROADWAY",
"city": "EVERETT",
"state": "WA",
"postal_code": "982013018",
"telephone_number": "425-252-4600"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STEWART",
"first_name": "JENNIFER",
"middle_name": "KRISTA",
"name_prefix": "Mrs.",
"credential": "PTA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-02-02",
"last_updated": "2024-02-07",
"certification_date": "2024-02-07",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "WA",
"license": "60340820",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Everett, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.