Individual
JAY HAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1211 24TH ST, ANACORTES, WA 98221-2557
(360) 293-3181
Mailing address
PO BOX 189, COUPEVILLE, WA 98239-0189
(360) 678-4071
(360) 678-6014
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
MD00022934
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
003319001
GROUP HEALTH
WA
01
—
0090258
DEPT LABOR INDUSTRIES
WA
01
—
050004992
RAILROAD MEDICARE
WA
05
—
1002740
—
WA
01
—
5085HA
REGENCE BLUE SHIELD
WA
Enumeration date
07/09/2006
Last updated
07/19/2010
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