Provider Demographics
NPI:1922244987
Name:CAPELL, JODIE ALIEZE (PT)
Entity Type:Individual
Prefix:MS
First Name:JODIE
Middle Name:ALIEZE
Last Name:CAPELL
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 1:25117 SW PARKWAY AVE STE D
Mailing Address - Street 2:
Mailing Address - City:WILSONVILLE
Mailing Address - State:OR
Mailing Address - Zip Code:97070-9697
Mailing Address - Country:US
Mailing Address - Phone:503-570-3665
Mailing Address - Fax:503-570-9155
Practice Address - Street 1:5340 N BRISTOL ST
Practice Address - Street 2:
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98407-2204
Practice Address - Country:US
Practice Address - Phone:253-756-6259
Practice Address - Fax:866-556-7521
Is Sole Proprietor?:No
Enumeration Date:2008-12-22
Last Update Date:2021-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPT00008093225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist