JODY GUSTAFSON (NPI# 1053655860) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1053655860 |
| Entity Type | Individual |
| Full Name | JODY GUSTAFSON |
| Practice Address |
3330 Monte Villa Pkwy Bothell WA 98021-8972 |
| Mailing Address |
19705 88th Ave Ne Bothell WA 98011-2121 |
| Practice Telephone | 4254085570 |
| Enumeration Date | 2012-11-16 |
| Last Update Date | 2012-11-16 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2251P0200X |
Physical Therapist Specialization: Pediatrics |
PT 00002619 | WA | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Street Address |
3330 MONTE VILLA PKWY |
| City | BOTHELL |
| State | WA |
| Zip Code | 98021-8972 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649211491 | Megan Larson | Speech-Language Pathologist | 3330 Monte Villa Pkwy, Bothell, WA 98021-8972 | 2006-06-10 |
| 1619501848 | Megan Thaman | Registered Nurse | 3330 Monte Villa Pkwy, Bothell, WA 98021-8972 | 2020-02-26 |
| 1952935363 | Yuet Juhn Tse | Psychologist | 3330 Monte Villa Pkwy, Bothell, WA 98021-8972 | 2020-02-24 |
| 1073168076 | Jesus Anthony Silva | Social Worker | 3330 Monte Villa Pkwy, Bothell, WA 98021-8972 | 2019-08-06 |
| 1790248615 | Emily C Tabet | Speech-Language Pathologist | 3330 Monte Villa Pkwy, Bothell, WA 98021-8972 | 2019-04-08 |
| 1972065258 | Andrew Nevett | Registered Nurse | 3330 Monte Villa Pkwy, Bothell, WA 98021-8972 | 2019-04-04 |
| 1194299610 | Jennifer Liang | Occupational Therapist | 3330 Monte Villa Pkwy, Bothell, WA 98021-8972 | 2019-01-17 |
| 1578030532 | Jan Stemple | Registered Nurse | 3330 Monte Villa Pkwy, Bothell, WA 98021-8972 | 2018-10-29 |
| 1184191405 | Michelle Song | Registered Nurse | 3330 Monte Villa Pkwy, Bothell, WA 98021-8972 | 2018-10-24 |
| 1922502905 | Sheryl Lynn Bowers | Registered Nurse | 3330 Monte Villa Pkwy, Bothell, WA 98021-8972 | 2018-03-22 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265057780 | Seyed Ali Hosseini | Medical Genetics | 4299 233rd Pl Se, Bothell, WA 98021 | 2020-06-10 |
| 1710440359 | Hiu Nam Wong | Specialist/Technologist | 23419 17th Avenue Southeast, Bothell, WA 98021 | 2019-04-10 |
| 1578029823 | Andrea Lynn Whipple | Speech-Language Pathologist | 1909 124th Street Se, Suite 204, Bothell, WA 98021 | 2019-02-12 |
| 1730656604 | Pavittar Kaur Mansahia | Registered Nurse | Northshore School District, 3330 Monte Villa Parkway, Bothell, WA 98021 | 2018-10-30 |
| 1699261636 | Kellie Joan Wilcox Moore | Naturopath | 2210 242nd St Sw, Bothell, WA 98021 | 2018-07-02 |
| 1174970495 | Tracey Comella | Behavioral Analyst | 2020 Maltby Road Suite 7 Pmb 294, Bothell, WA 98021 | 2016-05-17 |
| 1912332545 | Katherine Marie Zintel | Counselor | 1909 214th St Se Ste 204, Bothell, WA 98021 | 2013-09-13 |
| 1720332471 | Sharon Lynne Deering | Speech-Language Pathologist | 3330 Monte Villa Parkway, Northshore School District, Bothell, WA 98021 | 2012-11-02 |
| 1225302722 | Lynette Patricia Hansen | Massage Therapist | 510 222nd Street Sw, Bothell, WA 98021 | 2012-03-01 |
| 1669749891 | Susie Fox | Dietitian, Registered | 4026 224th St Se#6, Bothell, WA 98021 | 2011-11-16 |
| Find all providers in zip 98021 | ||||
| Taxonomy Code | 2251P0200X |
| Grouping | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Classification | Physical Therapist |
| Specialization | Pediatrics |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285061382 | Julie Wilder Watson | Physical Therapist | 3330 Monte Villa Pkwy, Bothell, WA 98021-8972 | 2013-10-03 |
| 1477898567 | Sandra Lynne Melanson | Physical Therapist | 3330 Monte Villa Pkwy, Bothell, WA 98021-8972 | 2012-11-30 |
| 1912251802 | Kara Cecil | Physical Therapist | 3330 Monte Villa Pkwy, Bothell, WA 98021-8972 | 2012-10-31 |
| 1336436286 | Rita Flaim Larson | Physical Therapist | 18504 Bothell Way Ne, Bothell, WA 98011-1927 | 2011-06-29 |
| 1861724742 | Heidi Lee | Physical Therapist | 18504 Bothell Way Ne, Bothell, WA 98011-1927 | 2010-02-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003421280 | Nattika Detskultorn | Physical Therapist | 1301 4th Ave Nw Ste 100, Issaquah, WA 98027-9371 | 2020-09-14 |
| 1730704883 | The Mama and Baby Mobility Project | Physical Therapist | 2510 164th St Sw Apt E107, Lynnwood, WA 98087-7836 | 2020-06-15 |
| 1154951804 | Thea E Byrne | Physical Therapist | 6030 Bothell Everett Hwy, #140, Mill Creek, WA 98012 | 2020-01-22 |
| 1659854784 | Brady Glenn Christoph | Physical Therapist | Auburn School District, 29205 132nd Ave Se, Auburn, WA 98092 | 2018-09-14 |
| 1952760175 | Sharon Worden | Physical Therapist | 5005 Main St Apt 812, Tacoma, WA 98407-3166 | 2016-02-16 |
| 1619378643 | Angela Fritz | Physical Therapist | 2411 42nd Ave E, 177 G, Seattle, WA 98112-2547 | 2014-09-09 |
| 1053751669 | Katie Buck | Physical Therapist | 3801 Kern Road, Yakima, WA 98902-6340 | 2013-06-27 |
| 1063753846 | Christen L Davidson-juhnke | Physical Therapist | 1384 Havstad Dr, Walla Walla, WA 99362-9235 | 2013-03-04 |
| 1083950455 | Lalani Shelton | Physical Therapist | 1000 Lake Park Dr Sw, Tumwater, WA 98512-6912 | 2012-12-12 |
| 1568715209 | Janis Kathrein | Physical Therapist | 17119 Se 351st St, Auburn, WA 98092-3906 | 2012-10-18 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.