Jack Uriah Teague, P.T.

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT00000652 Issued in WA

Practice address

18107 Bothell Way NE
Suite 106
Bothell, WA 98011-1900

Phone

(425) 487-3142

Fax

(425) 487-8785

NPI assigned

Feb 7, 2007

Sex

Male

Sole proprietor

Yes

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)

Enrolled

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Avamere Outpatient Services, LLC

  • Physical Therapist
  • Bothell, WA
  • NPI 1710151311
  NPD (past)
• Northshore Physical Therapy

  • Physical Therapist
  • Bothell, WA
  • NPI 1548460090
  NPD (past)
• Merit Rehab, LLC

  • Physical Therapist
  • Cottage Grove, OR
  • NPI 1619285038
  NPD (past)

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

{
    "created_epoch": "1170806400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1207872000000",
    "number": "1992845192",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9209 126TH AVE NE",
            "city": "KIRKLAND",
            "state": "WA",
            "postal_code": "980335901",
            "telephone_number": "425-827-4758"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18107 BOTHELL WAY NE",
            "address_2": "SUITE 106",
            "city": "BOTHELL",
            "state": "WA",
            "postal_code": "980111900",
            "telephone_number": "425-487-3142",
            "fax_number": "425-487-8785"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TEAGUE",
        "first_name": "JACK",
        "middle_name": "URIAH",
        "credential": "P.T.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-07",
        "last_updated": "2008-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WA",
            "license": "PT00000652",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jeremy D Taylor, PHARM.D.
• Michelle Taylor, RPH
• Rosemarie Teresa Taylor
• Ross L Taylor, D.D.S.
• Stacey Marie Taylor
• Teeth R US
• Kathryn Margaret Telle, DC
• Elizabeth M Tenace, OT
• Emily Tenan
• Cheyenne Teneyck

• Physical Therapist in Bothell, WA
• Providers in Bothell, WA by specialty
• Physical Therapist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2008; 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.