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Individual

JACK E. SEBBEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1229 MADISON ST STE 1480, SEATTLE, WA 98104-3538
(206) 346-6647
Mailing address
1229 MADISON ST STE 1480, SEATTLE, WA 98104-3538
(206) 346-6647

Taxonomy

Speciality
Code
Description
License number
State
207ND0101X
MOHS-Micrographic Surgery Physician
C31669
CA
207ND0101X
MOHS-Micrographic Surgery Physician
Primary
MD00013487
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00C316690
CA
01
MD00013487
STATE OF WASHINGTON
WA
Enumeration date
11/01/2006
Last updated
10/06/2008
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