Provider Demographics
NPI:1629385935
Name:LANGLAND, JEMMA ROSE (PT, DPT)
Entity Type:Individual
Prefix:MRS
First Name:JEMMA
Middle Name:ROSE
Last Name:LANGLAND
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:JEMMA
Other - Middle Name:ROSE
Other - Last Name:HATAB
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 24269
Mailing Address - Street 2:
Mailing Address - City:FEDERAL WAY
Mailing Address - State:WA
Mailing Address - Zip Code:98093-1269
Mailing Address - Country:US
Mailing Address - Phone:253-874-5445
Mailing Address - Fax:253-874-0687
Practice Address - Street 1:35535 6TH PLACE SW
Practice Address - Street 2:
Practice Address - City:FEDERAL WAY
Practice Address - State:WA
Practice Address - Zip Code:98023
Practice Address - Country:US
Practice Address - Phone:253-874-5445
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-09-08
Last Update Date:2010-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPT601647872251P0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics