Individual
JILLIAN E WORTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1344 WINTERGREEN LN NE, BAINBRIDGE ISLAND, WA 98110
(206) 842-5632
(206) 842-5992
Mailing address
1344 WINTERGREEN LN NE, BAINBRIDGE ISLAND, WA 98110-5118
(206) 842-5632
(206) 842-5992
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD00039452
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0039581
LABOR AND INDUSTRIES #
WA
01
—
5539WO
BLUE SHIELD #
WA
05
—
8289944
—
WA
05
—
MD1566W
—
AK
01
—
US2578144
AETNA PCP PIN
WA
01
—
US2578147
AETNA SPECIALIST PIN
WA
Enumeration date
02/12/2007
Last updated
06/15/2018
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