Provider Demographics
NPI:1790070969
Name:MATTHEWS, JAMIL ANTHONY (MD)
Entity Type:Individual
Prefix:DR
First Name:JAMIL
Middle Name:ANTHONY
Last Name:MATTHEWS
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:4001 LAUREL ST STE 204
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99508-5300
Mailing Address - Country:US
Mailing Address - Phone:310-254-0465
Mailing Address - Fax:
Practice Address - Street 1:4011 TALBOT RD S STE 430
Practice Address - Street 2:
Practice Address - City:RENTON
Practice Address - State:WA
Practice Address - Zip Code:98055-5791
Practice Address - Country:US
Practice Address - Phone:425-690-3498
Practice Address - Fax:425-690-9498
Is Sole Proprietor?:No
Enumeration Date:2011-06-15
Last Update Date:2022-04-13
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AK1526202086S0129X
WAMD606837892086S0129X, 2086S0129X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular Surgery