Jerome, Keith Robert
Jerome, Keith Robert is an individual health care provider with primary practice located at Ambulatory Clinic 825 Eastlake Avenue East, Seattle WA 98109. He recently has only one registered license in Allopathic & Osteopathic Physicians / Clinical Pathology/Laboratory Medicine, which is considered as his primary health care specialty. Jerome, Keith Robert can be contacted via phone (206) 288-1000.Contact Information
Primary practice address
Ambulatory Clinic 825 Eastlake Avenue East
Seattle WA 98109
Phone: (206) 288-1000
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Clinical Pathology/Laboratory Medicine | 207ZP0105X | MD00036076 | Washington |
Profile Details
| NPI number | 1386724367 |
|---|---|
| LBN Legal business name | Jerome, Keith Robert |
| Credentials | |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Oct 16th, 2006 |
| Last updated | Feb 20th, 2013 - about 12 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 | 1386724367 | NPPES |
| Other | 1322 | INTERNAL ID-MOTOR VEHICLE ID | |
| MEDICAID | 1386724367 | INTERNAL ID-MOTOR VEHICLE ID | |
| Other | 0231435 | INTERNAL ID-MOTOR VEHICLE ID |
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