Healthcare Provider Details

I. General information

NPI: 1275038598
Provider Name (Legal Business Name): JESSE PAULSEN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/28/2018
Last Update Date: 05/25/2026
Certification Date: 05/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2271 NE 51ST ST
SEATTLE WA
98105-5713
US

IV. Provider business mailing address

2271 NE 51ST ST
SEATTLE WA
98105-5713
US

V. Phone/Fax

Practice location:
  • Phone: 206-809-7436
  • Fax: 251-276-6356
Mailing address:
  • Phone: 206-809-7436
  • Fax: 251-276-6356

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code2084A0401X
TaxonomyAddiction Medicine (Psychiatry & Neurology) Physician
License NumberMD61076434
License Number StateWA
# 3
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberMD61076434
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: