Provider Demographics
NPI:1487678629
Name:KIRKPATRICK, JOHN N (MD)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:N
Last Name:KIRKPATRICK
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 9TH AVE
Mailing Address - Street 2:MS:M4-PA
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98101-2756
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1100 9TH AVE
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98101-2756
Practice Address - Country:US
Practice Address - Phone:206-223-6600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-27
Last Update Date:2008-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD00015065207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA0039581OtherLABOR & INDUSTRY
WAUS0899784OtherAETNA/USHC PCP
WAMD1506AOtherALASKA MEDICAID
WAK430OtherBLUE SHIELD
WA110171360OtherRAILROAD MEDICARE
WA8265100Medicaid
WAK430OtherBLUE SHIELD
A04905Medicare UPIN
WA000181716Medicare PIN
WA8801411Medicare PIN