Provider Demographics
NPI:1477883155
Name:STEIERT, JERRY CARL (MD)
Entity Type:Individual
Prefix:DR
First Name:JERRY
Middle Name:CARL
Last Name:STEIERT
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 1:901 BOREN AVE
Mailing Address - Street 2:SUITE 1800
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98104-3595
Mailing Address - Country:US
Mailing Address - Phone:206-624-4587
Mailing Address - Fax:206-624-6975
Practice Address - Street 1:901 BOREN AVE
Practice Address - Street 2:SUITE 1800
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98104-3595
Practice Address - Country:US
Practice Address - Phone:206-624-4587
Practice Address - Fax:206-624-6975
Is Sole Proprietor?:No
Enumeration Date:2010-01-03
Last Update Date:2010-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD000110462084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAE57771Medicare UPIN