Provider Demographics
NPI:1831384734
Name:VERMEESCH, JAROD (PT, CSCS)
Entity type:Individual
Prefix:DR
First Name:JAROD
Middle Name:
Last Name:VERMEESCH
Suffix:
Gender:M
Credentials:PT, CSCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:29757 SW BOONES FERRY RD
Mailing Address - Street 2:
Mailing Address - City:WILSONVILLE
Mailing Address - State:OR
Mailing Address - Zip Code:97070-7202
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:344 HENSLEE DR
Practice Address - Street 2:SUITE 8
Practice Address - City:DICKSON
Practice Address - State:TN
Practice Address - Zip Code:37055-2051
Practice Address - Country:US
Practice Address - Phone:615-446-7623
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-09-13
Last Update Date:2016-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN7937225100000X
OR60647225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3727276Medicaid
TN3727276Medicare PIN