JOURDAN R GOTTLIEB (NPI# 1992883847) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1992883847 |
| Entity Type | Individual |
| Full Name | JOURDAN R GOTTLIEB |
| Credential | MD |
| Practice Address |
500 17th Ave Seattle WA 98122-5711 |
| Mailing Address |
Po Box 25608 Salt Lake City UT 84125-0608 |
| Practice Telephone | 2063202580 |
| Practice Fax Number | 2063204073 |
| Mailing Telephone | 2063204476 |
| Mailing Fax Number | 2065687043 |
| Enumeration Date | 2006-11-01 |
| Last Update Date | 2020-01-06 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 174400000X | Specialist | MD00023270 | WA | Other Service Providers |
| Y | 2086S0122X |
Surgery Specialization: Plastic and Reconstructive Surgery |
MD00023270 | WA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WA | 1992883847 | 05 |
| Street Address |
500 17TH AVE |
| City | SEATTLE |
| State | WA |
| Zip Code | 98122-5711 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255331377 | Dennis Chong | Physical Medicine & Rehabilitation | 500 17th Ave, Wound Healing Center, Seattle, WA 98122-5711 | 2005-07-29 |
| 1922613074 | Caitlin Vosburgh | Registered Nurse | 500 17th Ave, Seattle, WA 98122-5711 | 2020-09-14 |
| 1942819404 | Elias Mounir Elias | Neurological Surgery | 500 17th Ave, Seattle, WA 98122-5711 | 2020-07-29 |
| 1164057360 | Christine Ann Schmer | Registered Nurse | 500 17th Ave, Seattle, WA 98122-5711 | 2020-03-08 |
| 1821623257 | Kirsten Elizabeth Wickstrom | Registered Nurse | 500 17th Ave, Seattle, WA 98122-5711 | 2020-03-05 |
| 1508499039 | Hodo Mohamud | Registered Nurse | 500 17th Ave, Seattle, WA 98122-5711 | 2020-02-12 |
| 1639709728 | Marian J Dobles | Pharmacist | 500 17th Ave, Seattle, WA 98122-5711 | 2020-01-17 |
| 1659910008 | Ayrron Sisley | Pharmacist | 500 17th Ave, Seattle, WA 98122-5711 | 2020-01-02 |
| 1639718687 | Monica Ste Marie | Pharmacist | 500 17th Ave, Seattle, WA 98122-5711 | 2019-12-21 |
| 1124666268 | Michael Kwik | Pharmacist | 500 17th Ave, Seattle, WA 98122-5711 | 2019-12-19 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053938506 | Quality Counseling and Consultation Service LLC | Counselor | 1525 Harvard Ave #509, Seattle, WA 98122 | 2020-07-01 |
| 1912535626 | Cesar Andrade | Student in an Organized Health Care Education/Training Program | 550 16th Avenue #400, Seattle, WA 98122 | 2020-03-29 |
| 1366089666 | Peter Nguyen | Pharmacy Technician | 914 East Jefferson Street, Campion Hall, Seattle, WA 98122 | 2019-12-05 |
| 1356903140 | Jason Dandino | Specialist/Technologist | 550 14th Avenue, Seattle, WA 98122 | 2019-07-02 |
| 1962066415 | Seattle Colleges | Local Education Agency (LEA) | Mainstay At Seattle Central College, 1701 Broadway Ms Be3210, Seattle, WA 98122 | 2019-04-30 |
| 1538621412 | Mitchell R Ornelas | Student in an Organized Health Care Education/Training Program | Swedish Family Medicine Residency Cherry Hill; 550 16th, Avenue #400, Seattle, WA 98122 | 2019-04-01 |
| 1003374265 | Michael Russell | Surgery | 747 Broadway Heath Building 10th Floor, Seattle, WA 98122 | 2019-03-06 |
| 1639646821 | Maritza E Cajiao | Doula | 747 Broadway, Seattle, Seattle, WA 98122 | 2018-10-25 |
| 1336616762 | Suzanna M Lovin | Social Worker | 401 Broadway, 1st Floor, Seattle, WA 98122 | 2018-10-24 |
| 1184137770 | Walter Franklin Krengel Jr. | Orthopaedic Surgery | 2000 1st Ave Suite 2201, Seattle, WA 98122 | 2017-11-06 |
| Find all providers in zip 98122 | ||||
| Taxonomy Code | 2086S0122X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Surgery |
| Specialization | Plastic and Reconstructive Surgery |
| A surgeon who specializes in plastic and reconstructive surgery. |
| Notes: Source: National Uniform Claim Committee, 2009 [1/1/2010: definition added, source added] Additional Resources: A General Certificate is issued by the American Osteopathic Board of Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821154790 | Alexander Gougoutas | Surgery | 1560 N 115th St Ste 206, Seattle, WA 98133-8414 | 2006-12-28 |
| 1699337865 | Mert Calis | Surgery | 4800 Sand Point Way Ne, O.b.9.520, Seattle, WA 98105 | 2019-07-08 |
| 1114580396 | Christina Beck | Surgery | 325 9th Ave, Seattle, WA 98104 | 2019-04-15 |
| 1356760664 | Stephen Lee Viviano | Surgery | 1959 Ne Pacific St, Seattle, WA 98195-2425 | 2014-04-15 |
| 1447592282 | Howard Wang | Surgery | 4800 Sand Point Way Ne, Seattle, WA 98105-3901 | 2013-03-19 |
| 1982970513 | Eugene Oh | Surgery | 1550 N 115th St, Seattle, WA 98133 | 2012-03-28 |
| 1134435787 | William P Schmitt | Surgery | 1100 9th Ave, Seattle, WA 98101-2756 | 2010-08-20 |
| 1225342991 | Shannon Margaret Colohan | Surgery | 1959 Ne Pacific St, Uwmc Division of Plastic Surgery, Seattle, WA 98195-0001 | 2010-08-04 |
| 1073835427 | Downey Plastic Surgery Tr | Surgery | 1536 N 115th St, Suite 105, Seattle, WA 98133-8400 | 2010-02-25 |
| 1548402308 | Janelle Dubbins Sousa | Surgery | 1959 Ne Pacific St, Box 356410, Seattle, WA 98195-0001 | 2009-03-25 |
| Find all providers in SEATTLE | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.