Jade Trade Inc. | |
218 Washington Ave, Portland, ME 04101-2632 | |
(207) 773-5778 | |
(207) 773-5773 |
Full Name | Jade Trade Inc. |
---|---|
Type | Facility |
Speciality | Physical Therapist |
Location | 218 Washington Ave, Portland, Maine |
Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1578753836 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
171100000X | Acupuncturist | AC200 (Maine) | Secondary |
225100000X | Physical Therapist | PT2432 (* (Not Available)) | Primary |
225700000X | Massage Therapist | MT1458 (Maine) | Secondary |
Provider Name | Marsha L Domench |
---|---|
Provider Type | Practitioner - Physical Therapist In Private Practice |
Provider Identifiers | NPI Number: 1720048044 PECOS PAC ID: 2163464371 Enrollment ID: I20050527000426 |
Provider Name | Lisa J Reardon |
---|---|
Provider Type | Practitioner - Physical Therapist In Private Practice |
Provider Identifiers | NPI Number: 1457401093 PECOS PAC ID: 2365540184 Enrollment ID: I20070601000351 |
Provider Name | Jennifer K Major |
---|---|
Provider Type | Practitioner - Physical Therapist In Private Practice |
Provider Identifiers | NPI Number: 1790977908 PECOS PAC ID: 2567558786 Enrollment ID: I20071019000247 |
Provider Name | Nancy P Charlebois |
---|---|
Provider Type | Practitioner - Physical Therapist In Private Practice |
Provider Identifiers | NPI Number: 1407881584 PECOS PAC ID: 9032206453 Enrollment ID: I20071101000514 |
Provider Name | Melissa L Belcher |
---|---|
Provider Type | Practitioner - Physical Therapist In Private Practice |
Provider Identifiers | NPI Number: 1982637526 PECOS PAC ID: 3870758543 Enrollment ID: I20120702000190 |
Provider Name | Michelle S Sullivan |
---|---|
Provider Type | Practitioner - Physical Therapist In Private Practice |
Provider Identifiers | NPI Number: 1376727909 PECOS PAC ID: 6406080274 Enrollment ID: I20131010000022 |
Provider Name | Marie Boneparth |
---|---|
Provider Type | Practitioner - Physical Therapist In Private Practice |
Provider Identifiers | NPI Number: 1578778924 PECOS PAC ID: 5193010072 Enrollment ID: I20160817002474 |
Provider Name | Grace E Bedard |
---|---|
Provider Type | Practitioner - Physical Therapist In Private Practice |
Provider Identifiers | NPI Number: 1497265219 PECOS PAC ID: 8729342969 Enrollment ID: I20180516000126 |
Provider Name | Samantha Bowdenwood |
---|---|
Provider Type | Practitioner - Physical Therapist In Private Practice |
Provider Identifiers | NPI Number: 1053805689 PECOS PAC ID: 6800147448 Enrollment ID: I20180921000128 |
Provider Name | Erin Pike |
---|---|
Provider Type | Practitioner - Physical Therapist In Private Practice |
Provider Identifiers | NPI Number: 1467828996 PECOS PAC ID: 6608116231 Enrollment ID: I20190319001327 |
Provider Name | Angela Lee Depaola |
---|---|
Provider Type | Practitioner - Physical Therapist In Private Practice |
Provider Identifiers | NPI Number: 1396239695 PECOS PAC ID: 2365788619 Enrollment ID: I20191024002709 |
Provider Name | Sheri Ann Hopey |
---|---|
Provider Type | Practitioner - Physical Therapist In Private Practice |
Provider Identifiers | NPI Number: 1548543994 PECOS PAC ID: 8527234293 Enrollment ID: I20200910001908 |
Provider Name | Karen Wik |
---|---|
Provider Type | Practitioner - Physical Therapist In Private Practice |
Provider Identifiers | NPI Number: 1932652369 PECOS PAC ID: 6709173750 Enrollment ID: I20210112001955 |
Provider Name | Amanda Delorme |
---|---|
Provider Type | Practitioner - Occupational Therapist In Private Practice |
Provider Identifiers | NPI Number: 1720669294 PECOS PAC ID: 6709295553 Enrollment ID: I20210506001341 |
Provider Name | Barbara Baribeau |
---|---|
Provider Type | Practitioner - Physical Therapist In Private Practice |
Provider Identifiers | NPI Number: 1225700552 PECOS PAC ID: 9436548674 Enrollment ID: I20211110000787 |
Provider Name | Vanessa C Farrer |
---|---|
Provider Type | Practitioner - Physical Therapist In Private Practice |
Provider Identifiers | NPI Number: 1063851210 PECOS PAC ID: 9133446065 Enrollment ID: I20220720000224 |
Provider Name | Riley Shea |
---|---|
Provider Type | Practitioner - Physical Therapist In Private Practice |
Provider Identifiers | NPI Number: 1922726645 PECOS PAC ID: 5496123317 Enrollment ID: I20221128001998 |
Mailing Address | Practice Location Address |
---|---|
Jade Trade Inc. 218 Washington Ave, Portland, ME 04101-2632 Ph: (207) 773-5778 | Jade Trade Inc. 218 Washington Ave, Portland, ME 04101-2632 Ph: (207) 773-5778 |