Provider Demographics
NPI:1063476638
Name:RAMOS, JEFFREY JOHN (PT)
Entity Type:Individual
Prefix:
First Name:JEFFREY
Middle Name:JOHN
Last Name:RAMOS
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:27203 216TH AVE SE
Mailing Address - Street 2:SUITE 10
Mailing Address - City:MAPLE VALLEY
Mailing Address - State:WA
Mailing Address - Zip Code:98038-3274
Mailing Address - Country:US
Mailing Address - Phone:425-584-7441
Mailing Address - Fax:425-433-8214
Practice Address - Street 1:27203 216TH AVE SE
Practice Address - Street 2:SUITE 10
Practice Address - City:MAPLE VALLEY
Practice Address - State:WA
Practice Address - Zip Code:98038-3274
Practice Address - Country:US
Practice Address - Phone:425-584-7441
Practice Address - Fax:425-433-8214
Is Sole Proprietor?:No
Enumeration Date:2006-04-12
Last Update Date:2015-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPT00005024225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAG8851739Medicare PIN