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General NPI Number Information
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NPI Number | 1487809703
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Entity Type | Individual
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Provider Name | JAMIE R LITVACK M.D., M.S.
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Gender | Female
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Dates
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Enumeration Date | 12/01/2008
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Last Update Date | 01/31/2024
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Provider Practice Location Address
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Address Line | 3125 COLBY AVE STE J
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City | EVERETT
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State | WA
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Zip | 98201-4032
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Country | US
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Telephone | 425-791-3093
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Fax |
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Provider Business Mailing Address
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Address Line | 1728 W MARINE VIEW DR STE 111
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City | EVERETT
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State | WA
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Zip | 98201-2094
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Country | US
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Telephone | 425-259-4041
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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 | 207Y00000X
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Taxonomy Name | Otolaryngology Physician
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License Number | MD60628497
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License Number State | WA
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