Provider Demographics
NPI:1407274905
Name:DAI, JESSICA C (MD)
Entity Type:Individual
Prefix:
First Name:JESSICA
Middle Name:C
Last Name:DAI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:11911 NE 132ND ST STE 200
Mailing Address - Street 2:
Mailing Address - City:KIRKLAND
Mailing Address - State:WA
Mailing Address - Zip Code:98034-2900
Mailing Address - Country:US
Mailing Address - Phone:425-899-5800
Mailing Address - Fax:425-899-5806
Practice Address - Street 1:1911 NE 132ND ST
Practice Address - Street 2:SUITE 200
Practice Address - City:KIRKLAND
Practice Address - State:WA
Practice Address - Zip Code:98034-2900
Practice Address - Country:US
Practice Address - Phone:425-899-5800
Practice Address - Fax:425-899-5806
Is Sole Proprietor?:No
Enumeration Date:2014-04-01
Last Update Date:2022-06-30
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WA61237390208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology