Provider Demographics
NPI:1598559692
Name:WITTIG, JORIE FREITAG (MD)
Entity type:Individual
Prefix:MRS
First Name:JORIE
Middle Name:FREITAG
Last Name:WITTIG
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:JORIE
Other - Middle Name:CAMRYN
Other - Last Name:FREITAG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1959 NE PACIFIC STREET BOX : 356421
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98195-6421
Mailing Address - Country:US
Mailing Address - Phone:206-543-3605
Mailing Address - Fax:
Practice Address - Street 1:1959 NE PACIFIC STREET BOX : 356421
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98195-3653
Practice Address - Country:US
Practice Address - Phone:206-543-3605
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-05
Last Update Date:2025-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMDRE.ML.61679818390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program