Healthcare Provider Details
I. General information
NPI: 1912273855
Provider Name (Legal Business Name): JAMIE LYNN STOKKE MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 03/26/2012
Last Update Date: 07/24/2018
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
4800 SAND POINT WAY NE A-5950
SEATTLE WA
98105
US
IV. Provider business mailing address
4800 SAND POINT WAY NE A-5950
SEATTLE WA
98105-3901
US
V. Phone/Fax
- Phone: 206-987-2525
- Fax:
- Phone: 206-987-2525
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 208000000X |
| Taxonomy | Pediatrics Physician |
| License Number | ML60292863 |
| License Number State | WA |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2080P0207X |
| Taxonomy | Pediatric Hematology & Oncology Physician |
| License Number | MD60572500 |
| License Number State | WA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: