Provider Demographics
NPI:1326824814
Name:HEADSTRONG NW PLLC
Entity Type:Organization
Organization Name:HEADSTRONG NW PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRACTITIONER
Authorized Official - Prefix:
Authorized Official - First Name:JARED
Authorized Official - Middle Name:
Authorized Official - Last Name:FRIEDLY
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:509-240-9701
Mailing Address - Street 1:16906 N MAYFAIR DR
Mailing Address - Street 2:
Mailing Address - City:COLBERT
Mailing Address - State:WA
Mailing Address - Zip Code:99005-9292
Mailing Address - Country:US
Mailing Address - Phone:509-240-9701
Mailing Address - Fax:
Practice Address - Street 1:10103 N DIVISION ST STE 107
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99218-1383
Practice Address - Country:US
Practice Address - Phone:509-240-9701
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-08-31
Last Update Date:2023-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty