Healthcare Provider Details

I. General information

NPI: 1467879320
Provider Name (Legal Business Name): JAYASRI IYER M.D
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/27/2014
Last Update Date: 04/22/2026
Certification Date: 04/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9924 NE 185TH ST STE 215
BOTHELL WA
98011-3504
US

IV. Provider business mailing address

7600 EVERGREEN WAY
EVERETT WA
98203-6421
US

V. Phone/Fax

Practice location:
  • Phone: 425-595-3830
  • Fax: 425-595-3831
Mailing address:
  • Phone: 206-860-5414
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License NumberMD60774413
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: