Provider Demographics
NPI:1093936015
Name:HASTINGS, JENNIFER D (PT PHD, NCS)
Entity Type:Individual
Prefix:PROF
First Name:JENNIFER
Middle Name:D
Last Name:HASTINGS
Suffix:
Gender:F
Credentials:PT PHD, NCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:27707 106TH AVE SE
Mailing Address - Street 2:
Mailing Address - City:KENT
Mailing Address - State:WA
Mailing Address - Zip Code:98030-8773
Mailing Address - Country:US
Mailing Address - Phone:253-212-7925
Mailing Address - Fax:253-879-3518
Practice Address - Street 1:27707 106TH AVE SE
Practice Address - Street 2:
Practice Address - City:KENT
Practice Address - State:WA
Practice Address - Zip Code:98030-8773
Practice Address - Country:US
Practice Address - Phone:253-212-7925
Practice Address - Fax:253-879-3518
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-01
Last Update Date:2015-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPT00003438225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist