Individual
JIMY E GILLETTE
Active
Individual
JIMY E GILLETTE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
MD00043162
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0039581
LABOR & INDUSTRY
WA
01
—
6914GI
BLUE SHIELD
WA
05
—
8390767
—
WA
01
—
US7405495
AETNA/USHC SPECIALIST
WA
Enumeration date
08/30/2006
Last updated
02/01/2013
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