Provider Demographics
NPI:1952748402
Name:MAJI, JEREMY M
Entity Type:Individual
Prefix:MR
First Name:JEREMY
Middle Name:M
Last Name:MAJI
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1414 116TH AVE NE STE C
Mailing Address - Street 2:
Mailing Address - City:BELLEVUE
Mailing Address - State:WA
Mailing Address - Zip Code:98004-3801
Mailing Address - Country:US
Mailing Address - Phone:425-646-7472
Mailing Address - Fax:425-453-1123
Practice Address - Street 1:1414 116TH AVE NE STE C
Practice Address - Street 2:
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98004-3801
Practice Address - Country:US
Practice Address - Phone:425-646-7472
Practice Address - Fax:425-453-1123
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-23
Last Update Date:2013-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARN00167175163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse