Provider Demographics
NPI:1659777571
Name:WASHABAUGH, JENNA MARIE (DPT)
Entity Type:Individual
Prefix:
First Name:JENNA
Middle Name:MARIE
Last Name:WASHABAUGH
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:JENNA
Other - Middle Name:MARIE
Other - Last Name:STETLER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DPT
Mailing Address - Street 1:720 E BROAD ST
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43215-3988
Mailing Address - Country:US
Mailing Address - Phone:614-224-1090
Mailing Address - Fax:614-224-1090
Practice Address - Street 1:720 E BROAD ST
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43215-3988
Practice Address - Country:US
Practice Address - Phone:614-224-1090
Practice Address - Fax:614-224-1090
Is Sole Proprietor?:No
Enumeration Date:2014-11-05
Last Update Date:2014-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH0149662251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic