Active NPI
Jennifer L Leis, MPT
- Physical Therapist
- Seattle, WA
National Provider Identifier
1962543363
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT00007494
- Practice address
- 1600 E Jefferson St
Suite a-5
Seattle, WA 98122-5698 - Phone
- (206) 320-2404
- Fax
- (206) 320-4747
- NPI assigned
- Feb 9, 2007
- 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 Therapist | 225100000X | PT00007494 | WA | Primary |
Addresses
Primary practice location
1600 E Jefferson St
Suite a-5
Seattle, WA 98122-5698
Mailing address
6307 22ND Ave NE
Seattle, WA 98115-6919
Phone (206) 320-5434
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 |
|---|---|---|---|
| PT00007494 | WA | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1170979200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1962543363",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6307 22ND AVE NE",
"city": "SEATTLE",
"state": "WA",
"postal_code": "981156919",
"telephone_number": "206-320-5434",
"fax_number": "206-320-4747"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1600 E JEFFERSON ST",
"address_2": "SUITE A-5",
"city": "SEATTLE",
"state": "WA",
"postal_code": "981225698",
"telephone_number": "206-320-2404",
"fax_number": "206-320-4747"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEIS",
"first_name": "JENNIFER",
"middle_name": "L",
"name_prefix": "Ms.",
"credential": "MPT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-02-09",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "WA",
"license": "PT00007494",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Seattle, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.