Healthcare Provider Details

I. General information

NPI: 1548036197
Provider Name (Legal Business Name): SREEJA JAMI
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/27/2023
Last Update Date: 08/21/2025
Certification Date: 08/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1416 NW 46TH ST STE 101
SEATTLE WA
98107-4622
US

IV. Provider business mailing address

18100 NE 95TH ST APT JJ2046
REDMOND WA
98052-3220
US

V. Phone/Fax

Practice location:
  • Phone: 206-783-0330
  • Fax:
Mailing address:
  • Phone: 425-589-5265
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License NumberDENT.DE.70006672
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: