Provider Demographics
NPI:1184980070
Name:FORBUS, JESSICA BRIDGET (MD)
Entity type:Individual
Prefix:DR
First Name:JESSICA
Middle Name:BRIDGET
Last Name:FORBUS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:JESSICA
Other - Middle Name:BRIDGET
Other - Last Name:SINOFF
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 1535
Mailing Address - Street 2:
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98401-1535
Mailing Address - Country:US
Mailing Address - Phone:253-761-4200
Mailing Address - Fax:253-383-3553
Practice Address - Street 1:1304 FAWCETT AVE STE 100
Practice Address - Street 2:
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98402-1900
Practice Address - Country:US
Practice Address - Phone:253-761-4200
Practice Address - Fax:253-761-4201
Is Sole Proprietor?:No
Enumeration Date:2012-04-05
Last Update Date:2024-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD608641902085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA0396130OtherLNI-TRA-MINW, PS-REST OF WA
WA0396134OtherLNI-UNION AVE OPEN MRI
WA0396135OtherLNI-DIAGNOSTIC IMAGING NORTHWEST
WA2106859Medicaid
WA0396132OtherLNI-TRA-MINW, PS-KING COUNTY
WA0396136OtherLNI-CAROL MILGARD BREAST CENTER