Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207P00000X | Emergency Physician | 291660 | NY |
Y | 207PE0004X | Emergency Medical Services | 60937363 | WA |
NPI | 1215381058 |
---|---|
Provider Name | Dr. Jamie Allen Ott |
First Address | Tacoma, WA 98406-6906 |
Second Address | Gig Harbor, WA 98332-5812 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 18/04/2016 |
Last Update Date | 04/12/2021 |