Provider Demographics
NPI:1629636709
Name:JAD3 P.S.
Entity Type:Organization
Organization Name:JAD3 P.S.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:NIALL
Authorized Official - Middle Name:C
Authorized Official - Last Name:DILLAN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:206-517-5433
Mailing Address - Street 1:7010 WOODLAWN AVE NE
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98115-5433
Mailing Address - Country:US
Mailing Address - Phone:206-517-5433
Mailing Address - Fax:206-517-5533
Practice Address - Street 1:7010 WOODLAWN AVE NE
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98115-5433
Practice Address - Country:US
Practice Address - Phone:206-517-5433
Practice Address - Fax:206-517-5533
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-06-03
Last Update Date:2019-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service