Individual
JESSE PETRICH MAUPIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1550 N 115TH ST, SEATTLE, WA 98133-8401
(206) 520-5000
Mailing address
PO BOX 50095, SEATTLE, WA 98145-5095
(206) 520-5700
(206) 520-3186
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
1235525965
WI
207R00000X
Internal Medicine Physician
MD61143898
WA
208M00000X
Hospitalist Physician
67559-20
WI
208M00000X
Hospitalist Physician
Primary
MD61143898
WA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1235525965
—
WA
Enumeration date
04/09/2015
Last updated
05/03/2022
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