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:
Health care specialties
| Specialty | Code | License # | 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1831167451 | NPPES |
| Washington | MEDICAID | 1020053 |
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