Individual
DR. JEREMY HENRY CONKLIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
999 N CURTIS RD STE 415, BOISE, ID 83706-1334
(208) 302-2600
(208) 302-2625
Mailing address
747 BROADWAY, SEATTLE, WA 98122-4307
(206) 215-2520
(206) 215-6364
Taxonomy
Speciality
Code
Description
License number
State
2086S0102X
Surgical Critical Care Physician
CDR.0002122
CO
2086S0102X
Surgical Critical Care Physician
Primary
OC-0435
ID
2086S0102X
Surgical Critical Care Physician
OP60816242
WA
364SC0200X
Critical Care Medicine Clinical Nurse Specialist
CDR.0002122
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1700830882
—
WA
Enumeration date
05/21/2006
Last updated
03/05/2024
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