Provider Demographics
NPI:1376060186
Name:HOFFMAN, JACOB NATHANIEL (DPT)
Entity Type:Individual
Prefix:
First Name:JACOB
Middle Name:NATHANIEL
Last Name:HOFFMAN
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2723 SUNSET CT
Mailing Address - Street 2:
Mailing Address - City:STEILACOOM
Mailing Address - State:WA
Mailing Address - Zip Code:98388-2817
Mailing Address - Country:US
Mailing Address - Phone:253-320-8961
Mailing Address - Fax:
Practice Address - Street 1:13106 SE 240TH ST STE 103
Practice Address - Street 2:
Practice Address - City:KENT
Practice Address - State:WA
Practice Address - Zip Code:98031-9211
Practice Address - Country:US
Practice Address - Phone:425-413-4427
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-08-23
Last Update Date:2017-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist