Provider Demographics
NPI:1407816838
Name:JENKINS, JANAE (ATC, CSCS)
Entity Type:Individual
Prefix:
First Name:JANAE
Middle Name:
Last Name:JENKINS
Suffix:
Gender:F
Credentials:ATC, CSCS
Other - Prefix:
Other - First Name:JANAE
Other - Middle Name:
Other - Last Name:LONGORIA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2008 PARKSIDE DR APT 138
Mailing Address - Street 2:
Mailing Address - City:BREMERTON
Mailing Address - State:WA
Mailing Address - Zip Code:98310-4320
Mailing Address - Country:US
Mailing Address - Phone:360-479-3279
Mailing Address - Fax:
Practice Address - Street 1:4060 WHEATON WAY STE C
Practice Address - Street 2:
Practice Address - City:BREMERTON
Practice Address - State:WA
Practice Address - Zip Code:98310-3500
Practice Address - Country:US
Practice Address - Phone:360-479-8477
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-03-28
Last Update Date:2008-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer