Provider Demographics
NPI:1740225119
Name:SEPKUTY, JEHUDA (MD)
Entity Type:Individual
Prefix:
First Name:JEHUDA
Middle Name:
Last Name:SEPKUTY
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 1:550 17TH AVE
Mailing Address - Street 2:SUITE 540
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98122-5788
Mailing Address - Country:US
Mailing Address - Phone:206-386-3886
Mailing Address - Fax:206-386-3882
Practice Address - Street 1:550 17TH AVE
Practice Address - Street 2:SUITE 540
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98122-5788
Practice Address - Country:US
Practice Address - Phone:206-386-3886
Practice Address - Fax:206-386-3882
Is Sole Proprietor?:No
Enumeration Date:2006-06-18
Last Update Date:2021-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA000484832084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD293000500Medicaid
MDG01292Medicare UPIN
MD293000500Medicaid