Provider Demographics
NPI:1932141900
Name:PAZEVIC, JON-PIERRE (DO)
Entity Type:Individual
Prefix:DR
First Name:JON-PIERRE
Middle Name:
Last Name:PAZEVIC
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:PO BOX 34936
Mailing Address - Street 2:DEPT 3028
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98124-1936
Mailing Address - Country:US
Mailing Address - Phone:888-398-2473
Mailing Address - Fax:
Practice Address - Street 1:21601 76TH AVE W
Practice Address - Street 2:
Practice Address - City:EDMONDS
Practice Address - State:WA
Practice Address - Zip Code:98026-7507
Practice Address - Country:US
Practice Address - Phone:425-640-4100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-12
Last Update Date:2009-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA0P0001250207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
910861251OtherPREMERA BC
168565OtherWA L & I
E24152OtherGROUP HEALTH
PA0145OtherREGENCE BS
WA8119174Medicaid
A003OtherCHAMPUS
CS1938Medicare PIN
A003OtherCHAMPUS
001246200Medicare PIN
PA0145OtherREGENCE BS
E24152Medicare UPIN