Healthcare Provider Details

I. General information

NPI: 1285674341
Provider Name (Legal Business Name): JAMES TRAVIS MAJORS MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/07/2006
Last Update Date: 12/07/2020
Certification Date: 12/07/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1818 COLE ST
ENUMCLAW WA
98022-3504
US

IV. Provider business mailing address

1818 COLE ST
ENUMCLAW WA
98022-3504
US

V. Phone/Fax

Practice location:
  • Phone: 360-802-5760
  • Fax:
Mailing address:
  • Phone: 360-802-5760
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberMD00042946
License Number StateWA

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

# 1
Identifier1043569
Identifier TypeMEDICAID
Identifier StateWA
Identifier Issuer
# 2
Identifier911203494BJ
Identifier TypeOTHER
Identifier StateWA
Identifier IssuerKPS PROVIDER NUMBER
# 3
Identifier0178829
Identifier TypeOTHER
Identifier StateWA
Identifier IssuerL & I PROVIDER NUMBER
# 4
Identifier4050268
Identifier TypeOTHER
Identifier StateWA
Identifier IssuerAETNA PROVIDER NUMBER
# 5
Identifier6688MA
Identifier TypeOTHER
Identifier StateWA
Identifier IssuerREGENCE RIDER NUMBER
# 6
Identifier8378010
Identifier TypeMEDICAID
Identifier StateWA
Identifier Issuer
# 7
Identifier98372D007
Identifier TypeOTHER
Identifier StateWA
Identifier IssuerTRICARE PROVIDER NUMBER

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: