Provider Demographics
NPI:1770045528
Name:STOKKE, JESSE MICHEAL (DO)
Entity Type:Individual
Prefix:
First Name:JESSE
Middle Name:MICHEAL
Last Name:STOKKE
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14015 N 94TH ST
Mailing Address - Street 2:APT 2077
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85260-3731
Mailing Address - Country:US
Mailing Address - Phone:253-653-9829
Mailing Address - Fax:
Practice Address - Street 1:HONORHEALTH JOMAX CLINIC
Practice Address - Street 2:26224 N. TATUM BLVD. #5
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85050
Practice Address - Country:US
Practice Address - Phone:480-882-7580
Practice Address - Fax:480-563-7442
Is Sole Proprietor?:No
Enumeration Date:2019-04-02
Last Update Date:2019-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program