Provider Demographics
NPI:1942537493
Name:ROOK, JODI LEIGH (PA-C)
Entity type:Individual
Prefix:
First Name:JODI
Middle Name:LEIGH
Last Name:ROOK
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:JODI
Other - Middle Name:LEIGH
Other - Last Name:DAIGEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:4903 108TH ST SW
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:WA
Mailing Address - Zip Code:98499-3724
Mailing Address - Country:US
Mailing Address - Phone:253-589-6484
Mailing Address - Fax:253-984-1079
Practice Address - Street 1:4903 108TH ST SW
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:WA
Practice Address - Zip Code:98499-3724
Practice Address - Country:US
Practice Address - Phone:253-584-3577
Practice Address - Fax:253-984-1079
Is Sole Proprietor?:No
Enumeration Date:2009-11-04
Last Update Date:2025-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPA60057919363A00000X, 363AM0700X
CA53663363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical