Provider Demographics
NPI:1568411494
Name:MACS, JURIS M (MD)
Entity Type:Individual
Prefix:DR
First Name:JURIS
Middle Name:M
Last Name:MACS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:1006 N H ST
Mailing Address - Street 2:5TH FLOOR
Mailing Address - City:ABERDEEN
Mailing Address - State:WA
Mailing Address - Zip Code:98520-2521
Mailing Address - Country:US
Mailing Address - Phone:360-537-6414
Mailing Address - Fax:360-532-6878
Practice Address - Street 1:1006 N H ST
Practice Address - Street 2:5TH FLOOR
Practice Address - City:ABERDEEN
Practice Address - State:WA
Practice Address - Zip Code:98520-2521
Practice Address - Country:US
Practice Address - Phone:360-537-6414
Practice Address - Fax:360-532-6878
Is Sole Proprietor?:No
Enumeration Date:2006-05-08
Last Update Date:2013-10-02
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WAMD00010490208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAA003OtherTRICARE
WAMA1607OtherCOUNTY
WA022161238OtherMEDICARE RR PROVIDER
WA8914472OtherCRIME VICTIMS
WA115141600OtherMEDICARE GROUP
WA000800078OtherMEDICARE PROVIDER
WA1532605Medicaid
WADC4850OtherRR MEDICARE
WA335846100OtherUS DEPT OF LABOR
WA0012648OtherWA LI PROVIDER
WA115141600OtherMEDICARE GROUP