Provider Demographics
NPI:1669660726
Name:JENKINS, JAMIE A (MD)
Entity Type:Individual
Prefix:DR
First Name:JAMIE
Middle Name:A
Last Name:JENKINS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:JAMIE
Other - Middle Name:A
Other - Last Name:GOODIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:2232 DAY ISLAND BLVD W
Mailing Address - Street 2:
Mailing Address - City:UNIVERSITY PLACE
Mailing Address - State:WA
Mailing Address - Zip Code:98466-1810
Mailing Address - Country:US
Mailing Address - Phone:202-251-1617
Mailing Address - Fax:
Practice Address - Street 1:1717 S J ST
Practice Address - Street 2:
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98405-4933
Practice Address - Country:US
Practice Address - Phone:202-251-1617
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-10-12
Last Update Date:2023-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCMD038627207P00000X
CAA104934207P00000X
MDD70458207P00000X
WAMD60196364207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine