Provider Demographics
NPI:1447720800
Name:MEADS, JENNIFER LYNN (DPT)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:LYNN
Last Name:MEADS
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:JENNIFER
Other - Middle Name:LYNN
Other - Last Name:CRANSTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPT
Mailing Address - Street 1:3121 W KENNEWICK AVE
Mailing Address - Street 2:
Mailing Address - City:KENNEWICK
Mailing Address - State:WA
Mailing Address - Zip Code:99336-2921
Mailing Address - Country:US
Mailing Address - Phone:509-735-7433
Mailing Address - Fax:509-735-6577
Practice Address - Street 1:3121 W KENNEWICK AVE
Practice Address - Street 2:
Practice Address - City:KENNEWICK
Practice Address - State:WA
Practice Address - Zip Code:99336-2921
Practice Address - Country:US
Practice Address - Phone:509-735-7433
Practice Address - Fax:509-735-6577
Is Sole Proprietor?:No
Enumeration Date:2018-11-28
Last Update Date:2023-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
2255A2300X, 390200000X
WAPT61388079225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program