Individual
JACOB CAMERON BLOOM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1550 N 115TH ST, SEATTLE, WA 98133-8401
(206) 520-5000
Mailing address
PO BOX 50095, SEATTLE, WA 98145-5095
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
MD61543077
WA
207YX0007X
Plastic Surgery within the Head & Neck (Otolaryngology) Physician
Primary
MD61543077
WA
Other
Enumeration date
03/20/2019
Last updated
08/16/2024
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