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NPI Code Detail

MEDICARE: JAE SIM M.D.

MEDICARE: JAE SIM 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
1207Q00000XFamily Medicine Physician00035125WA

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 : 1497803712
Entity Type Code : Individual
Provider Name (Legal Business Name) : JAE SIM M.D.
Provider Business Mailing Address
First Line : 904 7TH AVE
Second Line :
City : SEATTLE
State : WA
Zip : 98104-1132
Country : US
Telephone Number : 206-860-2209
Fax Number : 206-720-7435
Provider Business Practice Location Address
First Line : 904 7TH AVE
Second Line :
City : SEATTLE
State : WA
Zip : 98104-1132
Country : US
Telephone Number : 206-329-1760
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/05/2007
Last Update Date : 05/21/2026

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