Provider Demographics
NPI:1972915601
Name:HAHN, JACLYN DURANT (PT, DPT)
Entity Type:Individual
Prefix:
First Name:JACLYN
Middle Name:DURANT
Last Name:HAHN
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:JACLYN
Other - Middle Name:
Other - Last Name:DURANT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1560 140TH AVE NE
Mailing Address - Street 2:SUITE 100
Mailing Address - City:BELLVUE
Mailing Address - State:WA
Mailing Address - Zip Code:98005
Mailing Address - Country:US
Mailing Address - Phone:425-746-2475
Mailing Address - Fax:425-746-2471
Practice Address - Street 1:3601 FREMONT AVE N
Practice Address - Street 2:SUITE 216
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98103
Practice Address - Country:US
Practice Address - Phone:206-548-1522
Practice Address - Fax:425-746-2471
Is Sole Proprietor?:No
Enumeration Date:2014-05-29
Last Update Date:2018-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPT604561332251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic