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General NPI Number Information
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NPI Number | 1194804161
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Entity Type | Individual
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Provider Name | MICHAEL ERIC JANSSEN MD
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Gender | Male
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Dates
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Enumeration Date | 11/02/2006
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Last Update Date | 10/07/2020
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Provider Practice Location Address
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Address Line | 5350 TALLMAN AVE NW SUITE 301
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City | SEATTLE
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State | WA
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Zip | 98107-5902
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Country | US
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Telephone | 206-320-3335
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Fax | 206-320-8027
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Provider Business Mailing Address
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Address Line | PO BOX 25608
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City | SALT LAKE CITY
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State | UT
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Zip | 84125-0608
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Country | US
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Telephone | 206-320-4476
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Fax | 206-233-7489
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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 | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | RT-1351
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License Number State | NH
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | TL1017
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License Number State | WY
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Taxonomy #3
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 13498
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License Number State | NH
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Taxonomy #4
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | MD60344899
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License Number State | WA
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