Provider Demographics
NPI:1902381049
Name:ACHESON, JANELLE E (PT, DPT)
Entity Type:Individual
Prefix:
First Name:JANELLE
Middle Name:E
Last Name:ACHESON
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:JANELLE
Other - Middle Name:E
Other - Last Name:KENNEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:104 W 9TH AVE
Mailing Address - Street 2:
Mailing Address - City:POST FALLS
Mailing Address - State:ID
Mailing Address - Zip Code:83854-9216
Mailing Address - Country:US
Mailing Address - Phone:208-777-9740
Mailing Address - Fax:208-777-8316
Practice Address - Street 1:104 W 9TH AVE
Practice Address - Street 2:
Practice Address - City:POST FALLS
Practice Address - State:ID
Practice Address - Zip Code:83854-9216
Practice Address - Country:US
Practice Address - Phone:208-777-9740
Practice Address - Fax:208-777-8316
Is Sole Proprietor?:No
Enumeration Date:2018-09-25
Last Update Date:2022-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WYPT-1835225100000X
WAPT60939787225100000X
IDPT-6220225100000X
ND2195225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist