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NPI Code Detail

MEDICARE: DR. JACOB R FLEET M.D.

MEDICARE: DR. JACOB R FLEET 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
1207R00000XInternal Medicine PhysicianMD00042503WA

Other Identifiers

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

General Provider Information

NPI Number : 1356347579
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JACOB R FLEET M.D.
Provider Business Mailing Address
First Line : 1560 N 115TH ST
Second Line : SUITE 106
City : SEATTLE
State : WA
Zip : 98133-8414
Country : US
Telephone Number : 206-368-1558
Fax Number : 206-368-5751
Provider Business Practice Location Address
First Line : 1550 N 115TH ST
Second Line :
City : SEATTLE
State : WA
Zip : 98133-8401
Country : US
Telephone Number : 206-368-1558
Fax Number : 206-368-5751
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/22/2005
Last Update Date : 02/05/2008

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