Provider Demographics
NPI:1033203849
Name:HITTI, JANE E (MD)
Entity Type:Individual
Prefix:
First Name:JANE
Middle Name:E
Last Name:HITTI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:909 N BROADWAY
Mailing Address - Street 2:PBO
Mailing Address - City:EVERETT
Mailing Address - State:WA
Mailing Address - Zip Code:98201-1409
Mailing Address - Country:US
Mailing Address - Phone:425-317-0699
Mailing Address - Fax:425-317-0291
Practice Address - Street 1:900 PACIFIC AVE
Practice Address - Street 2:4TH FLOOR
Practice Address - City:EVERETT
Practice Address - State:WA
Practice Address - Zip Code:98201-4168
Practice Address - Country:US
Practice Address - Phone:425-304-6165
Practice Address - Fax:425-304-6162
Is Sole Proprietor?:No
Enumeration Date:2006-10-03
Last Update Date:2009-02-03
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WAMD00030852207VM0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VM0101XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyMaternal & Fetal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA8150773Medicaid
WAG33286Medicare UPIN
WAG8878215Medicare PIN
WA8150773Medicaid