Healthcare Provider Details

I. General information

NPI: 1073756854
Provider Name (Legal Business Name): JARRAD MATTHEW SCARLETT M.D.,PH.D
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/09/2009
Last Update Date: 07/16/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4800 SAND POINT WAY NE M/S W-7830
SEATTLE WA
98105-3901
US

IV. Provider business mailing address

331 ELM ST
EVERETT WA
98203-1924
US

V. Phone/Fax

Practice location:
  • Phone: 206-987-2521
  • Fax: 206-987-2721
Mailing address:
  • Phone: 503-516-4870
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080P0206X
TaxonomyPediatric Gastroenterology Physician
License NumberMD60281759
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: