Provider Demographics
NPI:1629006135
Name:JAMIL, ANNISA L (MD)
Entity Type:Individual
Prefix:DR
First Name:ANNISA
Middle Name:L
Last Name:JAMIL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:1101 MADISON ST
Mailing Address - Street 2:STE 600
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98104-3501
Mailing Address - Country:US
Mailing Address - Phone:206-215-2020
Mailing Address - Fax:206-215-3870
Practice Address - Street 1:1101 MADISON ST
Practice Address - Street 2:STE 600
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98104-3501
Practice Address - Country:US
Practice Address - Phone:206-215-2020
Practice Address - Fax:206-215-2022
Is Sole Proprietor?:No
Enumeration Date:2006-06-30
Last Update Date:2024-01-03
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WA44821207W00000X
WAMD00044821207WX0009X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207WX0009XAllopathic & Osteopathic PhysiciansOphthalmologyGlaucoma Specialist
No207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA1014828Medicaid
WA8411357Medicaid
WAG8944641Medicare PIN