Provider Demographics
NPI:1033177035
Name:JOINT VENTURES THERAPEUTICS, PC
Entity Type:Organization
Organization Name:JOINT VENTURES THERAPEUTICS, PC
Other - Org Name:MAJERUS & CO. PHYSICAL THERAPY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:JODIE
Authorized Official - Middle Name:L
Authorized Official - Last Name:PASCHALL-MAJERUS
Authorized Official - Suffix:
Authorized Official - Credentials:MPT
Authorized Official - Phone:360-253-4020
Mailing Address - Street 1:16111 SE MCGILLIVRAY BLVD STE A
Mailing Address - Street 2:
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98683-9033
Mailing Address - Country:US
Mailing Address - Phone:360-253-4020
Mailing Address - Fax:360-604-9293
Practice Address - Street 1:109 S 65TH AVE
Practice Address - Street 2:STE 105
Practice Address - City:RIDGEFIELD
Practice Address - State:WA
Practice Address - Zip Code:98642-3407
Practice Address - Country:US
Practice Address - Phone:360-727-3877
Practice Address - Fax:360-727-3880
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-02
Last Update Date:2022-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA602034358261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical TherapyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA4877510001Medicare NSC