Healthcare Provider Details

I. General information

NPI: 1225394935
Provider Name (Legal Business Name): JESSE ABBOTT KLAFTER M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: JESSE ABBOTT KLAFTER

II. Dates (important events)

Enumeration Date: 04/06/2012
Last Update Date: 12/09/2022
Certification Date: 12/09/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 S 43RD ST
RENTON WA
98055-5714
US

IV. Provider business mailing address

1959 NE PACIFIC ST RM BB-527 BOX 356421
SEATTLE WA
98195-0001
US

V. Phone/Fax

Practice location:
  • Phone: 425-228-3440
  • Fax: 425-656-4214
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberMD 60495631
License Number StateWA
# 2
Primary TaxonomyY
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License NumberMD60495631
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: