MEDICARE: DR. JENNIFER M KLEIN DO

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	207Q00000X	Family Medicine Physician	OP60305926	WA

General Provider Information

NPI Number	:	1376863258
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JENNIFER M KLEIN DO

Provider Business Mailing Address
First Line	:	12345 LAKE CITY WAY NE # 3161
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98125-5401
Country	:	US
Telephone Number	:	206-880-3789
Fax Number	:	833-968-1124

Provider Business Practice Location Address
First Line	:	12345 LAKE CITY WAY NE # 3161
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98125-5401
Country	:	US
Telephone Number	:	206-880-3789
Fax Number	:	833-968-1124

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

Provider Enumeration Date	:	06/02/2010
Last Update Date	:	04/24/2024

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