Idjadi, Jeremy A
Idjadi, Jeremy A is an individual health care provider with primary practice located at 834 Sheridan St , Port Townsend WA 98368-2443. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Sports Medicine, Allopathic & Osteopathic Physicians / Orthopaedic Surgery. Allopathic & Osteopathic Physicians / Orthopaedic Surgery is his primary health care specialty. Idjadi, Jeremy A can be contacted via phone (360) 344-0400.Contact Information
Primary practice address
834 Sheridan St
Port Townsend WA 98368-2443
Phone: (360) 344-0400
Fax: (360) 344-0418
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Sports Medicine | 207XX0005X | MD00046591 | Washington |
| Allopathic & Osteopathic Physicians / Orthopaedic Surgery | 207X00000X | MD00046591 | Washington |
Profile Details
| NPI number | 1578659264 |
|---|---|
| LBN Legal business name | Idjadi, Jeremy A |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Oct 4th, 2006 |
| Last updated | Jun 8th, 2021 - about 3 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 | 1578659264 | NPPES |
| Washington | Other | P00669277 | MEDICARE RR KING CO. |
| Washington | Other | G8891350 | MEDICARE RR KING CO. |
| Washington | Other | G8862908 | MEDICARE RR KING CO. |
| Washington | Other | 0213802 | MEDICARE RR KING CO. |
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