Provider Demographics
NPI:1457978801
Name:JOINES, AUSTYN (PT)
Entity Type:Individual
Prefix:
First Name:AUSTYN
Middle Name:
Last Name:JOINES
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:AUSTYN
Other - Middle Name:
Other - Last Name:BYASSEE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1345 CENTER DR STE 100
Mailing Address - Street 2:
Mailing Address - City:MEDFORD
Mailing Address - State:OR
Mailing Address - Zip Code:97501-7945
Mailing Address - Country:US
Mailing Address - Phone:541-210-5674
Mailing Address - Fax:
Practice Address - Street 1:9419 COPPERTOP LOOP NE
Practice Address - Street 2:
Practice Address - City:BAINBRIDGE ISLAND
Practice Address - State:WA
Practice Address - Zip Code:98110-3647
Practice Address - Country:US
Practice Address - Phone:206-842-2428
Practice Address - Fax:206-842-2890
Is Sole Proprietor?:No
Enumeration Date:2020-07-01
Last Update Date:2022-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR63680225100000X
WA61271379225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR500782837Medicaid