Provider Demographics
NPI:1497054811
Name:PARVEEN, JINAT JAHAN (MD)
Entity Type:Individual
Prefix:
First Name:JINAT
Middle Name:JAHAN
Last Name:PARVEEN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4700 POINT FOSDICK DR NW
Mailing Address - Street 2:STE 102
Mailing Address - City:GIG HARBOR
Mailing Address - State:WA
Mailing Address - Zip Code:98335-1706
Mailing Address - Country:US
Mailing Address - Phone:253-853-2050
Mailing Address - Fax:253-853-2711
Practice Address - Street 1:4700 POINT FOSDICK DR NW
Practice Address - Street 2:STE 102
Practice Address - City:GIG HARBOR
Practice Address - State:WA
Practice Address - Zip Code:98335-1706
Practice Address - Country:US
Practice Address - Phone:253-853-2050
Practice Address - Fax:253-853-2711
Is Sole Proprietor?:No
Enumeration Date:2011-03-24
Last Update Date:2014-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
WAMD60421943207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAG8933601Medicare PIN
WAG8933602Medicare PIN