Provider Demographics
NPI:1750870309
Name:ROMICK, JAYDEE R (DPT)
Entity type:Individual
Prefix:DR
First Name:JAYDEE
Middle Name:R
Last Name:ROMICK
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 1:448 N WERTH BLVD
Mailing Address - Street 2:
Mailing Address - City:NEWBERG
Mailing Address - State:OR
Mailing Address - Zip Code:97132-7500
Mailing Address - Country:US
Mailing Address - Phone:503-901-3865
Mailing Address - Fax:
Practice Address - Street 1:448 N WERTH BLVD
Practice Address - Street 2:
Practice Address - City:NEWBERG
Practice Address - State:OR
Practice Address - Zip Code:97132-7500
Practice Address - Country:US
Practice Address - Phone:503-554-2479
Practice Address - Fax:503-554-3917
Is Sole Proprietor?:Yes
Enumeration Date:2018-05-08
Last Update Date:2021-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR62725225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty