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NPI Code Detail

MEDICARE: JACQUELINE BALL M.D.

MEDICARE: JACQUELINE BALL 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
12084P0800XPsychiatry PhysicianMD00042722WA

General Provider Information

NPI Number : 1730285305
Entity Type Code : Individual
Provider Name (Legal Business Name) : JACQUELINE BALL M.D.
Provider Business Mailing Address
First Line : 2600 SW HOLDEN ST
Second Line :
City : SEATTLE
State : WA
Zip : 98126-3505
Country : US
Telephone Number : 206-933-7214
Fax Number : 206-933-7005
Provider Business Practice Location Address
First Line : 2600 SW HOLDEN ST
Second Line :
City : SEATTLE
State : WA
Zip : 98126-3505
Country : US
Telephone Number : 206-933-7214
Fax Number : 206-933-7005
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/14/2006
Last Update Date : 07/31/2007

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Directions to “ JACQUELINE BALL M.D.” Practice Location

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