Provider Demographics
NPI:1134485147
Name:MARKOVITZ, JACOB (MD)
Entity type:Individual
Prefix:DR
First Name:JACOB
Middle Name:
Last Name:MARKOVITZ
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 1:2208 NW MARKET ST STE 513
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98107-4098
Mailing Address - Country:US
Mailing Address - Phone:206-403-1374
Mailing Address - Fax:206-844-2337
Practice Address - Street 1:2208 NW MARKET ST STE 513
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98107-4098
Practice Address - Country:US
Practice Address - Phone:206-403-1374
Practice Address - Fax:206-844-2337
Is Sole Proprietor?:No
Enumeration Date:2012-04-03
Last Update Date:2023-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD604841012084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry