Provider Demographics
NPI:1659300374
Name:ALLGAIER, JEFFREY TODD (MD)
Entity Type:Individual
Prefix:
First Name:JEFFREY
Middle Name:TODD
Last Name:ALLGAIER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:969 STEVENS DR STE 3A
Mailing Address - Street 2:
Mailing Address - City:RICHLAND
Mailing Address - State:WA
Mailing Address - Zip Code:99352-3558
Mailing Address - Country:US
Mailing Address - Phone:509-713-1315
Mailing Address - Fax:866-422-7049
Practice Address - Street 1:969 STEVENS DR STE 3A
Practice Address - Street 2:
Practice Address - City:RICHLAND
Practice Address - State:WA
Practice Address - Zip Code:99352-3558
Practice Address - Country:US
Practice Address - Phone:509-713-1315
Practice Address - Fax:866-422-7049
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-03
Last Update Date:2024-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD00046152207P00000X, 207QA0401X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QA0401XAllopathic & Osteopathic PhysiciansFamily MedicineAddiction Medicine
No207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA0227596OtherLIWA
WA2031254Medicaid
WA3075ALOtherBSWA
WA0218208OtherLIWA
WA605960012OtherUSDLAB
WA0209137OtherLIWA
WA3079ALOtherBSWA
WA8452922Medicaid
WA8946277OtherVICTIMS OF CRIME
WA3752ALOtherBSWA
WA0216265OtherLIWA
WA6593ALOtherBSWA
WA605960012OtherUSDLAB
WA3075ALOtherBSWA
WA0218208OtherLIWA
WA8946277OtherVICTIMS OF CRIME
WA0209137OtherLIWA