Provider Demographics
NPI:1396832572
Name:JAEGER, BRIAN DEAN (MD)
Entity Type:Individual
Prefix:
First Name:BRIAN
Middle Name:DEAN
Last Name:JAEGER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1100 E UNION ST STE 3D
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98122-3936
Mailing Address - Country:US
Mailing Address - Phone:206-295-4236
Mailing Address - Fax:
Practice Address - Street 1:8301 161ST AVE NE STE 300
Practice Address - Street 2:
Practice Address - City:REDMOND
Practice Address - State:WA
Practice Address - Zip Code:98052-3858
Practice Address - Country:US
Practice Address - Phone:425-885-3330
Practice Address - Fax:425-702-2474
Is Sole Proprietor?:No
Enumeration Date:2006-10-06
Last Update Date:2021-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD464212084P0800X
HIMD-81462084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI3433OtherALOHA CARE
HI00C0200844OtherHMSA
HIC00054-1Medicaid
HI3433OtherALOHA CARE