Provider Demographics
NPI:1154500098
Name:JAL, M.D., INC., P.S.
Entity Type:Organization
Organization Name:JAL, M.D., INC., P.S.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:A
Authorized Official - Last Name:LOMBARDI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:206-243-1100
Mailing Address - Street 1:16259 SYLVESTER RD SW
Mailing Address - Street 2:STE 501
Mailing Address - City:BURIEN
Mailing Address - State:WA
Mailing Address - Zip Code:98166-3049
Mailing Address - Country:US
Mailing Address - Phone:206-243-1100
Mailing Address - Fax:206-431-0835
Practice Address - Street 1:16259 SYLVESTER RD SW
Practice Address - Street 2:STE 501
Practice Address - City:BURIEN
Practice Address - State:WA
Practice Address - Zip Code:98166-3049
Practice Address - Country:US
Practice Address - Phone:206-243-1100
Practice Address - Fax:206-431-0835
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-28
Last Update Date:2007-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD00041178207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA7118797Medicaid
WA0164209OtherLABOR & INDUSTRY
WA7118797Medicaid