Provider Demographics
NPI:1902251457
Name:SASAKI, JODIE LYNN (MD, MS)
Entity type:Individual
Prefix:DR
First Name:JODIE
Middle Name:LYNN
Last Name:SASAKI
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Gender:F
Credentials:MD, MS
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Mailing Address - Street 1:3600 LIND AVE SW
Mailing Address - Street 2:SUITE 100 ATTN CREDENTIALING
Mailing Address - City:RENTON
Mailing Address - State:WA
Mailing Address - Zip Code:98057-4970
Mailing Address - Country:US
Mailing Address - Phone:425-690-2715
Mailing Address - Fax:
Practice Address - Street 1:660 SW 39TH ST STE 150
Practice Address - Street 2:
Practice Address - City:RENTON
Practice Address - State:WA
Practice Address - Zip Code:98057-4912
Practice Address - Country:US
Practice Address - Phone:425-690-3483
Practice Address - Fax:425-690-9083
Is Sole Proprietor?:No
Enumeration Date:2016-05-03
Last Update Date:2020-08-05
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Provider Licenses
StateLicense IDTaxonomies
WAMD61061243207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology