Healthcare Provider Details

I. General information

NPI: 1568044071
Provider Name (Legal Business Name): JAMIE GARRETT MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/23/2021
Last Update Date: 05/13/2026
Certification Date: 05/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1959 NE PACIFIC ST
SEATTLE WA
98195-0001
US

IV. Provider business mailing address

809 NW 97TH ST UNIT A
SEATTLE WA
98117-2212
US

V. Phone/Fax

Practice location:
  • Phone: 208-731-1116
  • Fax:
Mailing address:
  • Phone: 208-731-1116
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207ZP0102X
TaxonomyAnatomic Pathology & Clinical Pathology Physician
License Number87360-20
License Number StateWI
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License NumberMD70005489
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: