Active NPI
Jake Arnold Dodge, DPT
- Physical Therapist
- Shoreline, WA
National Provider Identifier
1932432887
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PU60095969
- Practice address
- 19235 15TH Ave NW
Richmond Beach Rehabilitation and Specialty Care
Shoreline, WA 98177 - Phone
- (206) 546-2666
- NPI assigned
- Sep 10, 2009
- Sex
- Male
- Sole proprietor
- Yes
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 Therapist | 225100000X | PU60095969 | WA | Primary |
Addresses
Primary practice location
19235 15TH Ave NW
Richmond Beach Rehabilitation and Specialty Care
Shoreline, WA 98177
Mailing address
19235 15TH Ave NW
Richmond Beach Rehabilitation and Specialty Care
Shoreline, WA 98177
Phone (206) 546-2666
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 |
|---|---|---|---|
| PU60095969 | WA | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1252540800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1252540800000",
"number": "1932432887",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "19235 15TH AVE NW",
"address_2": "RICHMOND BEACH REHABILITATION AND SPECIALTY CARE",
"city": "SHORELINE",
"state": "WA",
"postal_code": "98177",
"telephone_number": "206-546-2666"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "19235 15TH AVE NW",
"address_2": "RICHMOND BEACH REHABILITATION AND SPECIALTY CARE",
"city": "SHORELINE",
"state": "WA",
"postal_code": "98177",
"telephone_number": "206-546-2666"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DODGE",
"first_name": "JAKE",
"middle_name": "ARNOLD",
"credential": "DPT",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2009-09-10",
"last_updated": "2009-09-10",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "WA",
"license": "PU60095969",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Shoreline, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 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.