Andrew Steven Jack, MD, MSC, FRCSC

Primary specialty

Neurological Surgery PhysicianTaxonomy code 207T00000X

License

A160007 Issued in CA

Practice address

550 17TH Ave Ste 500
Seattle, WA 98122-5789

Phone

(206) 320-3782

NPI assigned

Jul 3, 2018

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1530576000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1560211200000",
    "number": "1992291793",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1050 JAMES ST UNIT 512",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981042787",
            "telephone_number": "425-961-2765"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "550 17TH AVE STE 500",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981225789",
            "telephone_number": "206-320-3782"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACK",
        "first_name": "ANDREW",
        "middle_name": "STEVEN",
        "name_prefix": "Dr.",
        "credential": "MD, MSC, FRCSC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-07-03",
        "last_updated": "2019-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "CA",
            "license": "A160007",
            "primary": true
        },
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "WA",
            "license": "60814093",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Farrah Jabeen, MBBCH,MRCS,FRCR
• Peter P Jabin, M.DIV., LMHCA
• Michael Thomas Jacezko
• David Paul Jachim, PH.D.
• Jack J Cordova
• Keira Jack
• Andrew Ryan Jackenheimer, M.D.
• Sarah E. Jackins, PT
• Renee Jackman
• Shay Jackman, ARNP

• Neurological Surgery Physician in Seattle, WA
• Providers in Seattle, WA by specialty
• Neurological Surgery Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2019; 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.