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Organization

JEFFREY F OLLIFFE, M.D.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MARK A MCCLARTY (OFFICE MANAGER)
(206) 624-1441
Entity
Organization

Contact information

Practice address
1120 CHERRY ST, SUITE: 320, SEATTLE, WA 98104-2044
(206) 624-6104
Mailing address
1120 CHERRY ST, SUITE: 320, SEATTLE, WA 98104-2044
(206) 624-6104

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD00023575
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1019371
WA
01
4079498
AETNA
WA
01
57243
L&I
WA
01
OL5050
REGENCE BLUE SHIELD
WA
Enumeration date
01/22/2008
Last updated
01/22/2008
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