Individual
DR. SIRISHA MADDIPOTI JAIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
2720 CLARE AVE, SUITE A, BREMERTON, WA 98310-3374
(360) 479-6154
(360) 479-5728
Mailing address
2520 CHERRY AVE, BREMERTON, WA 98310-4229
(360) 479-6154
(360) 479-5728
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
M6736
TX
207RH0003X
Hematology & Oncology Physician
Primary
MD60244388
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
8AQ630
BCBS
TX
Enumeration date
08/28/2007
Last updated
01/06/2012
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