Provider Demographics
NPI:1861824757
Name:TAMURA, JESSICA (DPT)
Entity Type:Individual
Prefix:
First Name:JESSICA
Middle Name:
Last Name:TAMURA
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2838 NW IVY LN
Mailing Address - Street 2:
Mailing Address - City:CAMAS
Mailing Address - State:WA
Mailing Address - Zip Code:98607-7958
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:16219 SE 12TH ST
Practice Address - Street 2:STE 100
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98683-8904
Practice Address - Country:US
Practice Address - Phone:360-253-4020
Practice Address - Fax:360-604-9293
Is Sole Proprietor?:No
Enumeration Date:2013-08-02
Last Update Date:2018-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist