Active NPI
Jettie M Person, MD
- Dermatology Physician
- Seattle, WA
National Provider Identifier
1720170723
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dermatology Physician
- License
- MD00022852
- Practice address
- 3834 49TH Ave NE
Seattle, WA 98105-5234 - Phone
- (206) 234-5721
- Fax
- (206) 729-9297
- NPI assigned
- Sep 28, 2006
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dermatology Physician | 207N00000X | MD00022852 | WA | Primary |
Addresses
Primary practice location
3834 49TH Ave NE
Seattle, WA 98105-5234
Mailing address
3834 49TH Ave NE
Seattle, WA 98105-5234
Phone (206) 234-5721
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD00022852 | WA | MD | Dermatology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159401600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1463443200000",
"number": "1720170723",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3834 49TH AVE NE",
"city": "SEATTLE",
"state": "WA",
"postal_code": "981055234",
"telephone_number": "206-234-5721"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3834 49TH AVE NE",
"city": "SEATTLE",
"state": "WA",
"postal_code": "981055234",
"telephone_number": "206-234-5721",
"fax_number": "206-729-9297"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PERSON",
"first_name": "JETTIE",
"middle_name": "M",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-09-28",
"last_updated": "2016-05-17",
"status": "A"
},
"taxonomies": [
{
"code": "207N00000X",
"taxonomy_group": "",
"desc": "Dermatology",
"state": "WA",
"license": "MD00022852",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Seattle, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 17, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.