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Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

JODY WELCKER PROVINE, PTA

Active Sole Proprietor

JODY WELCKER PROVINE, PTA is a Skilled Nursing Facility healthcare provider located in NORTH BEND, Washington. NPI 1841669272 is currently active in the NPPES registry. Verify at CMS.

Skilled Nursing Facility · NORTH BEND, WA

Registration Details

NPI Number
1841669272
Provider Type
Individual
Gender
Female
NPI Issued
Sep 16, 2015 (10.889490490535 yrs)
Last Updated
Sep 16, 2015
Sole Proprietor
Yes

Practice Information

Address
219 CEDAR AVE S
NORTH BEND, WA, 980458262
Browse WA providers · Browse ZIP 98045
Phone
4258882129
Primary Specialty
Skilled Nursing Facility
314000000X
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.