Jason Andrew Agtarap, MD

Individual provider Active NPI Student in an Organized Health Care Education/Training Program · Seattle, WA

NPI 1194576181 · NPPES record last updated Apr 11, 2024

Key facts

NPI
1194576181
Entity type
Individual (NPI type 1)
Primary specialty
Student in an Organized Health Care Education/Training Program 390200000X
Practice address
925 Seneca St
Seattle, WA 98101-2742
Phone
(206) 624-1144
NPI assigned
Mar 28, 2024
Sex
Male
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Enrolled in WA
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20240529002898 WA Order and Referring Only - Diagnostic Radiology
Practitioner - Diagnostic Radiology
9133561699

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Doctor of Medicine

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X Yes

Addresses

Primary practice location

925 Seneca St
Seattle, WA 98101-2742

Mailing address

925 Seneca St
Mailstop H8-Gme
Seattle, WA 98101-2742

Other providers in Seattle, WA

All providers in Seattle, WA · Student in an Organized Health Care Education/Training Program in Washington

Sources for this page

Verify at the official NPI Registry.