DR. JEREMY HENRY CONKLIN (NPI# 1700830882) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1700830882 |
Entity Type | Individual |
Full Name | DR. JEREMY HENRY CONKLIN |
Credential | DO |
Practice Address |
747 Broadway Seattle WA 98122-4379 |
Mailing Address |
747 Broadway Seattle WA 98122-4307 |
Practice Telephone | 2062152520 |
Practice Fax Number | 2062156364 |
Mailing Telephone | 2062152520 |
Mailing Fax Number | 2062156364 |
Enumeration Date | 2006-05-21 |
Last Update Date | 2020-04-24 |
Gender Code | M |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 2086S0102X |
Surgery Specialization: Surgical Critical Care |
OP60816242 | WA | Allopathic & Osteopathic Physicians |
State | Issuer | Identifier | Type Code |
---|---|---|---|
WA | 1700830882 | 05 |
Street Address |
747 BROADWAY |
City | SEATTLE |
State | WA |
Zip Code | 98122-4379 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1215935960 | Marilee M. Jensen | Registered Nurse | 747 Broadway, Seattle, WA 98122-4379 | 2005-07-07 |
1366058919 | Mairghread Foley | Registered Nurse | 747 Broadway, Seattle, WA 98122-4307 | 2020-09-18 |
1891301628 | Jessica C Kelley | Registered Nurse | 747 Broadway, Seattle, WA 98122-4307 | 2020-09-17 |
1972116010 | Lindsey Gervascio | Registered Nurse | 747 Broadway, Seattle, WA 98122-4379 | 2020-08-28 |
1669097572 | Jisun Park | Dietitian, Registered | 747 Broadway, Seattle, WA 98122-4379 | 2020-06-16 |
1023633187 | Hang Hoang-nguyen | Pharmacist | 747 Broadway, Seattle, WA 98122-4307 | 2020-06-14 |
1558981357 | Caitlin Elizabeth Busbee | Student in an Organized Health Care Education/Training Program | 747 Broadway, Seattle, WA 98122-4307 | 2020-04-21 |
1164041323 | Emma Ludesi Makoba | Student in an Organized Health Care Education/Training Program | 747 Broadway, Seattle, WA 98122-4379 | 2020-04-08 |
1043849375 | Kaitlin Jane Byerly | Student in an Organized Health Care Education/Training Program | 747 Broadway, Seattle, WA 98122-4307 | 2020-04-07 |
1649809161 | Jia Hui Wang | Student in an Organized Health Care Education/Training Program | 747 Broadway, Seattle, WA 98122-4307 | 2020-04-06 |
Find all providers in the same location |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1053938506 | Quality Counseling and Consultation Service LLC | Counselor | 1525 Harvard Ave #509, Seattle, WA 98122 | 2020-07-01 |
1912535626 | Cesar Andrade | Student in an Organized Health Care Education/Training Program | 550 16th Avenue #400, Seattle, WA 98122 | 2020-03-29 |
1366089666 | Peter Nguyen | Pharmacy Technician | 914 East Jefferson Street, Campion Hall, Seattle, WA 98122 | 2019-12-05 |
1356903140 | Jason Dandino | Specialist/Technologist | 550 14th Avenue, Seattle, WA 98122 | 2019-07-02 |
1962066415 | Seattle Colleges | Local Education Agency (LEA) | Mainstay At Seattle Central College, 1701 Broadway Ms Be3210, Seattle, WA 98122 | 2019-04-30 |
1538621412 | Mitchell R Ornelas | Student in an Organized Health Care Education/Training Program | Swedish Family Medicine Residency Cherry Hill; 550 16th, Avenue #400, Seattle, WA 98122 | 2019-04-01 |
1003374265 | Michael Russell | Surgery | 747 Broadway Heath Building 10th Floor, Seattle, WA 98122 | 2019-03-06 |
1639646821 | Maritza E Cajiao | Doula | 747 Broadway, Seattle, Seattle, WA 98122 | 2018-10-25 |
1336616762 | Suzanna M Lovin | Social Worker | 401 Broadway, 1st Floor, Seattle, WA 98122 | 2018-10-24 |
1184137770 | Walter Franklin Krengel Jr. | Orthopaedic Surgery | 2000 1st Ave Suite 2201, Seattle, WA 98122 | 2017-11-06 |
Find all providers in zip 98122 |
Taxonomy Code | 2086S0102X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | Surgery |
Specialization | Surgical Critical Care |
A surgeon with expertise in the management of the critically ill and postoperative patient, particularly the trauma victim, who specializes in critical care medicine diagnoses, treats and supports patients with multiple organ dysfunction. This specialist may have administrative responsibilities for intensive care units and may also facilitate and coordinate patient care among the primary physician, the critical care staff and other specialists. |
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Surgery, 2007. http://www.absurgery.org/. American Osteopathic Board of Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Surgery. |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1538351036 | Edgar Jose Figueredo II | Surgery | 1959 Ne Pacific St, C212, Box 356340, Seattle, WA 98195-0001 | 2007-08-17 |
1073611489 | Saman Arbabi | Surgery | 325 9th Ave, Box 359796, Seattle, WA 98104-2420 | 2006-09-20 |
1639286123 | Sharmila D Dissanaike | Surgery | 1959 Ne Pacific St, C-212, Box 356340, Seattle, WA 98195-6340 | 2006-08-23 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1891233250 | Teresa D. Bell, Md, LLC | Surgery | 2522 N Proctor St # 42, Tacoma, WA 98406-5338 | 2017-02-06 |
1902123094 | Linda Ding | Surgery | 1321 Colby Ave, Everett, WA 98201-1665 | 2010-04-28 |
1902090061 | Khaled Rashad Pharaon | Surgery | 505 Ne 87th Ave, Suite 301, Vancouver, WA 98664-1989 | 2007-08-31 |
1033313820 | Long Duc Tran | Surgery | 315 Martin Luther King Jr. Way, Mailstop 315-j1--trauma, Tacoma, WA 98415-0299 | 2007-06-13 |
1861431330 | Philip Patrick Alford | Surgery | 4815 N Assembly St, Department of Surgery, Spokane, WA 99205-6185 | 2006-06-06 |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.