Individual
JACK JIAKUN TIAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
325 9TH AVE, SEATTLE, WA 98104-2420
(206) 520-5000
Mailing address
PO BOX 50095, SEATTLE, WA 98145-5095
(206) 520-5700
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
MD204184
OR
207W00000X
Ophthalmology Physician
Primary
MD61252434
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1669907911
—
WA
Enumeration date
04/25/2017
Last updated
01/31/2023
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