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:
Map and Directions

Health care specialties

SpecialtyCodeLicense #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 5 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 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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