Provider Demographics
NPI:1497832687
Name:POSTFOROOSH, JILLIANN (PT)
Entity Type:Individual
Prefix:
First Name:JILLIANN
Middle Name:
Last Name:POSTFOROOSH
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:37624 SE FURY ST
Mailing Address - Street 2:# C-201
Mailing Address - City:SNOQUALMIE
Mailing Address - State:WA
Mailing Address - Zip Code:98065-9680
Mailing Address - Country:US
Mailing Address - Phone:206-605-8919
Mailing Address - Fax:425-820-2111
Practice Address - Street 1:12707 120TH AVE NE
Practice Address - Street 2:SUITE 100
Practice Address - City:KIRKLAND
Practice Address - State:WA
Practice Address - Zip Code:98034-7500
Practice Address - Country:US
Practice Address - Phone:425-820-2110
Practice Address - Fax:425-820-2111
Is Sole Proprietor?:No
Enumeration Date:2006-11-01
Last Update Date:2016-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPT00007971225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA8346769Medicaid
WA8346769Medicaid
WAPO8021Medicare UPIN