Provider Demographics
NPI:1285854661
Name:BRUETT, JAYME L (DPT)
Entity Type:Individual
Prefix:MRS
First Name:JAYME
Middle Name:L
Last Name:BRUETT
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:MS
Other - First Name:JAYME
Other - Middle Name:L
Other - Last Name:STEVENS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:111 TUMWATER BLVD SE STE 113
Mailing Address - Street 2:
Mailing Address - City:TUMWATER
Mailing Address - State:WA
Mailing Address - Zip Code:98501-6422
Mailing Address - Country:US
Mailing Address - Phone:360-528-3300
Mailing Address - Fax:360-489-0040
Practice Address - Street 1:15446 BEL RED RD STE B10
Practice Address - Street 2:
Practice Address - City:REDMOND
Practice Address - State:WA
Practice Address - Zip Code:98052-5525
Practice Address - Country:US
Practice Address - Phone:360-528-3300
Practice Address - Fax:360-489-0040
Is Sole Proprietor?:No
Enumeration Date:2007-04-26
Last Update Date:2017-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA7112923Medicaid
WAAB28195Medicare ID - Type UnspecifiedGROUP