Healthcare Provider Details

I. General information

NPI: 1962583609
Provider Name (Legal Business Name): CRAIG JAFFE MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/18/2006
Last Update Date: 07/03/2023
Certification Date: 06/28/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 5TH AVE
SEATTLE WA
98104-2332
US

IV. Provider business mailing address

500 5TH AVE
SEATTLE WA
98104-2332
US

V. Phone/Fax

Practice location:
  • Phone: 206-477-6350
  • Fax: 206-296-1771
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0802X
TaxonomyAddiction Psychiatry Physician
License NumberMD00042565
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: