Provider Demographics
NPI:1437289147
Name:PATEL, JIGISH S (MD)
Entity Type:Individual
Prefix:
First Name:JIGISH
Middle Name:S
Last Name:PATEL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:JIGISHBHAI
Other - Middle Name:S
Other - Last Name:PATEL
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:19020 33RD AVE W
Mailing Address - Street 2:SUITE 210
Mailing Address - City:LYNNWOOD
Mailing Address - State:WA
Mailing Address - Zip Code:98036-4746
Mailing Address - Country:US
Mailing Address - Phone:425-563-1500
Mailing Address - Fax:425-563-1374
Practice Address - Street 1:19020 33RD AVE W
Practice Address - Street 2:SUITE 210
Practice Address - City:LYNNWOOD
Practice Address - State:WA
Practice Address - Zip Code:98036-4746
Practice Address - Country:US
Practice Address - Phone:425-563-1500
Practice Address - Fax:425-563-1374
Is Sole Proprietor?:No
Enumeration Date:2007-03-06
Last Update Date:2022-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD000472912085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAG8882841OtherPTAN-TRA PIERCE CO
WAG8883120OtherPTAN-MIO1
WALNI EVERGREEN RADIAOther0354223
WALNI SWEDISH RADIAOther0354221
WA0251374OtherLABOR AND INDUSTRIES-TRA
WA0251390OtherLABOR AND INDUSTRIES-UNION AVENUE OPEN MRI
WALNI RADIA-KING CTYOther0354217
WA0251385OtherLABOR AND INDUSTRIES-MEDICAL IMAGING ON 1ST
WA2001566Medicaid
WAG8882842OtherPTAN-TRA KING CO
WAG8882900OtherPTAN-UAOM
WALNI RADIA-REST OF WAOther0354216
WALNI SWEDISH RADIAOther0354221
WAG8882900OtherPTAN-UAOM
WA0251390OtherLABOR AND INDUSTRIES-UNION AVENUE OPEN MRI
WAG8952584Medicare PIN