Blackwell, Jeffrey S

Blackwell, Jeffrey S is an individual health care provider with primary practice located at 3927 Rucker Ave , Everett WA 98201-4833. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Blackwell, Jeffrey S can be contacted via phone (425) 339-5422.

Contact Information

Primary practice address
3927 Rucker Ave Everett WA 98201-4833
Phone: (425) 339-5422
Fax: (425) 339-5444
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 29693 Washington
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X MD00029693 Washington

Profile Details

NPI number 1831167451
LBN Legal business name Blackwell, Jeffrey S
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 9th, 2006
Last updated Jul 31st, 2020 - about 4 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1831167451 NPPES
Washington MEDICAID 1020053

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