Healthcare Provider Details

I. General information

NPI: 1255403622
Provider Name (Legal Business Name): JAMIE ANN MCKEEHAN MASSIE M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/14/2006
Last Update Date: 09/30/2025
Certification Date: 09/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1231 116TH AVE NE STE 705
BELLEVUE WA
98004-3804
US

IV. Provider business mailing address

1231 116TH AVE NE STE 705
BELLEVUE WA
98004-3804
US

V. Phone/Fax

Practice location:
  • Phone: 206-515-0000
  • Fax:
Mailing address:
  • Phone: 206-515-0000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberMD60636963
License Number StateWA
# 2
Primary TaxonomyY
Taxonomy Code207VE0102X
TaxonomyReproductive Endocrinology Physician
License NumberMD60636963
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: