Individual
DR. JABI ELIJAH SHRIKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3417 ENSIGN ROAD NE, OLYMPIA, WA 98506-5075
(360) 493-4609
(360) 493-4603
Mailing address
3417 ENSIGN ROAD NE, OLYMPIA, WA 98506-5075
(360) 493-4609
(360) 493-4603
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
MD60179553
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A794540
—
CA
01
—
0269721
L&I PROVIDER #
WA
01
—
G8896082
MEDICARE PTAN
WA
01
—
P00404582
RAIL ROAD MEDICARE
CA
Enumeration date
07/03/2006
Last updated
06/25/2013
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