| Mackenzie Nicole Jackson, PT, DPT | |
|
11212 Sunrise Blvd E Ste 202, Puyallup, WA 98374-8847 | |
| (253) 435-0360 | |
| (253) 435-0325 |
| Full Name | Mackenzie Nicole Jackson |
|---|---|
| Gender | Female |
| Speciality | Physical Therapist |
| Location | 11212 Sunrise Blvd E Ste 202, Puyallup, Washington |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1356955751 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 225100000X | Physical Therapist | 5501019681 (Michigan) | Secondary |
| 225100000X | Physical Therapist | PT61528942 (Washington) | Primary |
| Provider Name | Mdrs Spine & Sport Inc |
|---|---|
| Provider Type | Part B Supplier - Physical/occupational Therapy Group In Private Practice |
| Provider Identifiers | NPI Number: 1952394603 PECOS PAC ID: 3274446687 Enrollment ID: O20031111000725 |
| Provider Name | On The Move Rehab |
|---|---|
| Provider Type | Part B Supplier - Clinic/group Practice |
| Provider Identifiers | NPI Number: 1356710925 PECOS PAC ID: 6709195316 Enrollment ID: O20151022000752 |
| Mailing Address | Practice Location Address |
|---|---|
| Mackenzie Nicole Jackson, PT, DPT 11212 Sunrise Blvd E Ste 202, Puyallup, WA 98374-8847 Ph: (253) 435-0360 | Mackenzie Nicole Jackson, PT, DPT 11212 Sunrise Blvd E Ste 202, Puyallup, WA 98374-8847 Ph: (253) 435-0360 |
Peter Kelley Janicki, PT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 3912 10th St Se, Suite 101, Puyallup, WA 98374 Phone: 253-848-4700 Fax: 253-848-2284 | |
Mr. Jonas Cline, Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 400 29th St Ne, Puyallup, WA 98372 Phone: 253-840-4400 | |
Justin Higa, DPT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 1450 5th St Se Ste 4400, Puyallup, WA 98372 Phone: 253-881-1362 Fax: 253-881-1368 | |
Sara Kerrick, M.S., PT Physical Therapist Medicare: Medicare Enrolled Practice Location: 402 15th Ave Se, #100, Puyallup, WA 98372 Phone: 253-607-5200 Fax: 253-697-5145 | |
Marilee J Fijalka-carr, M.P.T. Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 402 15th Ave Se, #100, Puyallup, WA 98372 Phone: 253-697-5200 Fax: 253-697-5145 | |
Dr. Tyler Trudeau, DPT Physical Therapist Medicare: Accepting Medicare Assignments Practice Location: 1420 3rd St Se, Ste. 102, Puyallup, WA 98372 Phone: 253-770-1807 Fax: 253-770-1985 | |
Brooke Ferraro, PT, DPT Physical Therapist Medicare: Accepting Medicare Assignments Practice Location: 1707 3rd St Se, Puyallup, WA 98372 Phone: 253-841-3041 |