IndividualActive
Jody Gustafson
NPI 1053655860 · Pediatric Physical Therapist · Bothell, WA
Provider details
- NPI number
- 1053655860
- Entity type
- Individual
- Primary specialty
- Pediatric Physical TherapistRespiratory, Developmental, Rehabilitative and Restorative Service Providers
- Sex
- Female
- Sole proprietor
- No
- License
- PT 00002619 (WA)
Specialties & taxonomies
Respiratory, Developmental, Rehabilitative and Restorative Service Providers
Practice location
3330 Monte Villa Pkwy
Bothell, WA 98021-8972
Phone: (425) 408-5570
Approximate (ZIP-level) locationGet directions
Mailing address
19705 88th Ave Ne
Bothell, WA 98011-2121
Registry dates
- Enumerated
- 2012-11-16
- Last updated
- 2012-11-16
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.