MEDICARE: DR. JAY DAVIS SPRENGER 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	207RA0201X	Allergy & Immunology (Internal Medicine) Physician	MD00014739	WA
2	207K00000X	Allergy & Immunology Physician	MD00014739	WA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1306893334
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JAY DAVIS SPRENGER M.D.

Provider Business Mailing Address
First Line	:	9725 3RD AVE NE
Second Line	:	#500
City	:	SEATTLE
State	:	WA
Zip	:	98115-2060
Country	:	US
Telephone Number	:	206-527-1200
Fax Number	:	206-524-6927

Provider Business Practice Location Address
First Line	:	9725 3RD AVE NE
Second Line	:	#500
City	:	SEATTLE
State	:	WA
Zip	:	98115-2060
Country	:	US
Telephone Number	:	206-527-1200
Fax Number	:	206-524-6927

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

Provider Enumeration Date	:	05/27/2006
Last Update Date	:	02/13/2013

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