Provider Demographics
NPI:1295820694
Name:JARVIK, JEFFREY G (MD, MPH)
Entity Type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:G
Last Name:JARVIK
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Gender:M
Credentials:MD, MPH
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Mailing Address - Street 1:1959 NE PACIFIC STREET BOX 357115
Mailing Address - Street 2:UNIVERSITY OF WASHINGTON DEPARTMENT OF RADIOLOGY
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98195-7115
Mailing Address - Country:US
Mailing Address - Phone:206-598-3271
Mailing Address - Fax:206-598-8475
Practice Address - Street 1:1959 NE PACIFIC STREET
Practice Address - Street 2:UNIVERSITY OF WASHINGTON DEPARTMENT OF RADIOLOGY
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98195-7115
Practice Address - Country:US
Practice Address - Phone:206-598-3271
Practice Address - Fax:206-598-8475
Is Sole Proprietor?:No
Enumeration Date:2006-10-03
Last Update Date:2018-09-21
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Provider Licenses
StateLicense IDTaxonomies
WAMD000293102085N0700X, 2085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
No2085N0700XAllopathic & Osteopathic PhysiciansRadiologyNeuroradiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA1295820694Medicaid