Provider Demographics
NPI:1306893334
Name:SPRENGER, JAY DAVIS (MD)
Entity type:Individual
Prefix:DR
First Name:JAY
Middle Name:DAVIS
Last Name:SPRENGER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:9725 3RD AVE NE
Mailing Address - Street 2:#500
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98115-2060
Mailing Address - Country:US
Mailing Address - Phone:206-527-1200
Mailing Address - Fax:206-524-6927
Practice Address - Street 1:9725 3RD AVE NE
Practice Address - Street 2:#500
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98115-2060
Practice Address - Country:US
Practice Address - Phone:206-527-1200
Practice Address - Fax:206-524-6927
Is Sole Proprietor?:No
Enumeration Date:2006-05-27
Last Update Date:2013-02-13
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WAMD00014739207RA0201X, 207K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & Immunology
No207RA0201XAllopathic & Osteopathic PhysiciansInternal MedicineAllergy & Immunology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA1306893334Medicaid
I33461Medicare UPIN
WA8854204Medicare PIN
WA8854205Medicare PIN
WA8892752Medicare PIN