Provider Demographics
NPI:1477114056
Name:KEATON, JESSIE RUTH (DPT)
Entity type:Individual
Prefix:DR
First Name:JESSIE
Middle Name:RUTH
Last Name:KEATON
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:JESSIE
Other - Middle Name:RUTH
Other - Last Name:LESAR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPT
Mailing Address - Street 1:5150 MAE ANNE AVE STE 405
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89523-1859
Mailing Address - Country:US
Mailing Address - Phone:775-997-4131
Mailing Address - Fax:
Practice Address - Street 1:3603 S MCCLELLAN ST
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98144-5615
Practice Address - Country:US
Practice Address - Phone:206-535-7536
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-06-25
Last Update Date:2025-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist