Provider Demographics
NPI:1619901576
Name:DR JEFFERY BRITTIN FAMILY MEDICINE PLLC INC
Entity Type:Organization
Organization Name:DR JEFFERY BRITTIN FAMILY MEDICINE PLLC INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JEFFERY
Authorized Official - Middle Name:
Authorized Official - Last Name:BRITTIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:206-937-5356
Mailing Address - Street 1:PO BOX 16187
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98116-0187
Mailing Address - Country:US
Mailing Address - Phone:206-439-2988
Mailing Address - Fax:
Practice Address - Street 1:4744 41ST AVE SW
Practice Address - Street 2:SUITE 106
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98116-4570
Practice Address - Country:US
Practice Address - Phone:206-937-5356
Practice Address - Fax:206-937-5366
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-10
Last Update Date:2008-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD00032329207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAG12751Medicare UPIN
WA8801954Medicare PIN