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General NPI Number Information
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NPI Number | 1164690046
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Entity Type | Individual
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Provider Name | JASON DEEN M.D.
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Gender | Male
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Dates
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Enumeration Date | 02/13/2008
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Last Update Date | 11/04/2013
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Provider Practice Location Address
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Address Line | 4745 49TH AVE NE
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City | SEATTLE
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State | WA
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Zip | 98105-3829
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Country | US
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Telephone | 612-310-2277
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Fax |
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Provider Business Mailing Address
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Address Line | 4745 30TH AVE NE
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City | SEATTLE
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State | WA
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Zip | 98105-5501
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Country | US
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Telephone | 206-769-3012
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2080P0202X
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Taxonomy Name | Pediatric Cardiology Physician
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License Number | MD60143659
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License Number State | WA
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Taxonomy #2
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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