Individual
JIMY E GILLETTE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
19116 33RD AVE W, LYNNWOOD, WA 98036-4706
(425) 771-7500
(425) 712-7903
Mailing address
1100 OLIVE WAY MSC M4-PA, SEATTLE, WA 98101-1873
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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