Provider Demographics
NPI:1912353277
Name:UNNI, JAYKUMAR
Entity type:Individual
Prefix:
First Name:JAYKUMAR
Middle Name:
Last Name:UNNI
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1941 EAST RD
Mailing Address - Street 2:SUITE 3236
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77054-6010
Mailing Address - Country:US
Mailing Address - Phone:713-486-2570
Mailing Address - Fax:713-486-2565
Practice Address - Street 1:400 NE MOTHER JOSEPH PL
Practice Address - Street 2:
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98664-3200
Practice Address - Country:US
Practice Address - Phone:360-256-2000
Practice Address - Fax:360-514-2458
Is Sole Proprietor?:No
Enumeration Date:2016-05-05
Last Update Date:2024-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXS36062084P0800X
390200000X
WAMD615873272084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program