Jack John Calabria, DO

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

OP00000789 Issued in WA

Practice address

5410B Barnes Ave NW
Seattle, WA 98107-3839

Phone

(206) 782-9530

Fax

(206) 782-0184

NPI assigned

Nov 21, 2006

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Jack Calabria Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1164067200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1508931353",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5410B BARNES AVE NW",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981073839",
            "telephone_number": "206-782-9530",
            "fax_number": "206-782-0184"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5410B BARNES AVE NW",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981073839",
            "telephone_number": "206-782-9530",
            "fax_number": "206-782-0184"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CALABRIA",
        "first_name": "JACK",
        "middle_name": "JOHN",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-21",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WA",
            "license": "OP00000789",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LABOR & INDUSTRIES",
            "identifier": "5881",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1037274",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JACK",
            "last_name": "CALABRIA",
            "credential": "DO",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Maritza E Cajiao
• Daniel L Cajina
• Selin Elizabeth Caka, LMFTA
• Julie Cake, MA, LMHC
• Daniel Russell Calabrese, M.D.
• Barrett Calabro, M.S.,CCC-SLP
• Vivian Grace Calamiong
• Karen Bartolome Calara, MSPT
• Marie Kathleen Joy B. Calaro, MD
• Lisa Calavetta

• Family Medicine Physician in Seattle, WA
• Providers in Seattle, WA by specialty
• Family Medicine Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.