MEDICARE: DR. JILL ROSETTA VARNI M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207V00000X	Obstetrics & Gynecology Physician	025209 MD00017190	WA

General Provider Information

NPI Number	:	1003184839
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JILL ROSETTA VARNI M.D.

Provider Business Mailing Address
First Line	:	9923 LAKE WASHINGTON BLVD NE
Second Line	:
City	:	BELLEVUE
State	:	WA
Zip	:	98004-6068
Country	:	US
Telephone Number	:	425-505-2159
Fax Number	:

Provider Business Practice Location Address
First Line	:	9923 LAKE WASHINGTON BLVD NE
Second Line	:
City	:	BELLEVUE
State	:	WA
Zip	:	98004-6068
Country	:	US
Telephone Number	:	425-505-2159
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/07/2011
Last Update Date	:	12/07/2011

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