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General NPI Number Information
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NPI Number | 1740861814
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Entity Type | Individual
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Provider Name | MICHEAL JACE TARVER MD
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Gender | Male
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Dates
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Enumeration Date | 04/19/2021
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Last Update Date | 05/02/2025
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Provider Practice Location Address
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Address Line | 13001 E 17TH PL
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City | AURORA
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State | CO
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Zip | 80045-2570
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Country | US
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Telephone | 303-724-6021
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Fax |
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Provider Business Mailing Address
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Address Line | 1730 MINOR AVE STE 300
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City | SEATTLE
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State | WA
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Zip | 98101-1474
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Country | US
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Telephone | 206-386-2550
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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 | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 0071791
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License Number State | CO
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Taxonomy #2
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 61645439
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License Number State | WA
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