Individual
MR. JEFFREY FRED OLLIFFE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1817 12TH AVENUE, SEATTLE, WA 98122
(206) 624-6104
(206) 724-0618
Mailing address
1817 12TH AVENUE, SEATTLE, WA 98122
(206) 624-6104
(206) 724-0618
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
23575
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
080013515
RAILROAD MEDICARE #
WA
05
—
1019371
—
WA
01
—
4079498
AETNA PROVIDER NUMBER
WA
01
—
57243
L & I PROVIDER #
WA
01
—
OL5050
REGENCE PROVIDER NUMBER
WA
Enumeration date
08/17/2005
Last updated
09/30/2015
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