Provider Demographics
NPI:1730285412
Name:JAFFEE, MIRIAM ABIGAIL (ARNP)
Entity Type:Individual
Prefix:MS
First Name:MIRIAM
Middle Name:ABIGAIL
Last Name:JAFFEE
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 34036
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98124-1036
Mailing Address - Country:US
Mailing Address - Phone:425-899-3292
Mailing Address - Fax:425-899-3269
Practice Address - Street 1:12303 NE 130TH LN
Practice Address - Street 2:SUITE 225
Practice Address - City:KIRKLAND
Practice Address - State:WA
Practice Address - Zip Code:98034-3099
Practice Address - Country:US
Practice Address - Phone:425-899-3890
Practice Address - Fax:425-899-3889
Is Sole Proprietor?:No
Enumeration Date:2006-09-16
Last Update Date:2021-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP30006872363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA1230JAOtherREGENCE BLUE SHIELD
WA9644691Medicaid
WA7172808OtherAETNA
WA213491OtherLABOR & INDUSTRIES
WA9644691Medicaid
WAG8862559Medicare PIN