Provider Demographics
NPI:1093974008
Name:HILE, JAMI (PTA)
Entity Type:Individual
Prefix:MS
First Name:JAMI
Middle Name:
Last Name:HILE
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17600 N 79TH AVE APT 727
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85308-8687
Mailing Address - Country:US
Mailing Address - Phone:785-630-0285
Mailing Address - Fax:
Practice Address - Street 1:32300 1ST AVE S
Practice Address - Street 2:
Practice Address - City:FEDERAL WAY
Practice Address - State:WA
Practice Address - Zip Code:98003-5762
Practice Address - Country:US
Practice Address - Phone:253-874-3580
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-04
Last Update Date:2019-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ7817A225200000X
KS14-01243225200000X
MDA4253225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant