Prutkin, Jordan M
Prutkin, Jordan M is an individual health care provider with primary practice located at 1959 Ne Pacific St , Seattle WA 98195-6340. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Cardiovascular Disease, Allopathic & Osteopathic Physicians / Clinical Cardiac Electrophysiology. Allopathic & Osteopathic Physicians / Clinical Cardiac Electrophysiology is his primary health care specialty. Prutkin, Jordan M can be contacted via phone (206) 543-0065.Contact Information
Primary practice address
1959 Ne Pacific St
Seattle WA 98195-6340
Phone: (206) 543-0065
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Cardiovascular Disease | 207RC0000X | MD00044698 | Washington |
| Allopathic & Osteopathic Physicians / Clinical Cardiac Electrophysiology | 207RC0001X | MD00044698 | Washington |
Profile Details
| NPI number | 1760597488 |
|---|---|
| LBN Legal business name | Prutkin, Jordan M |
| Credentials | M.D., M.H.S. |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Aug 21st, 2006 |
| Last updated | Nov 21st, 2012 - 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 | 1760597488 | NPPES |
| Washington | MEDICAID | 1760597488 | |
| Washington | Other | 0250653 |
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