Provider Demographics
NPI:1992169536
Name:NOMITCH, JAMIE TREADWAY (MD)
Entity type:Individual
Prefix:DR
First Name:JAMIE
Middle Name:TREADWAY
Last Name:NOMITCH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:JAMIE
Other - Middle Name:PUALANI
Other - Last Name:TREADWAY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1959 NE PACIFIC ST
Mailing Address - Street 2:BB1226 HEALTH SCIENCES BUILDING BOX 356522
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98195-6522
Mailing Address - Country:US
Mailing Address - Phone:206-616-8378
Mailing Address - Fax:206-685-8673
Practice Address - Street 1:1959 NE PACIFIC ST
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98195-6522
Practice Address - Country:US
Practice Address - Phone:206-616-8378
Practice Address - Fax:206-685-8673
Is Sole Proprietor?:No
Enumeration Date:2016-04-10
Last Update Date:2022-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD.61050189207R00000X
IL036148888207R00000X
390200000X
WAMD.MD.61050189207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program