Basic Information
| Provider Information | |||||||||
| NPI: | 1548246689 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | HOYT | ||||||||
| FirstName: | JEANNA | ||||||||
| MiddleName: | M | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1101 MADISON ST | ||||||||
| Address2: | SUITE 600 | ||||||||
| City: | SEATTLE | ||||||||
| State: | WA | ||||||||
| PostalCode: | 981041306 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2062152004 | ||||||||
| FaxNumber: | 2062152055 | ||||||||
| Practice Location | |||||||||
| Address1: | 155 NE 100TH ST | ||||||||
| Address2: | SUITE 110 | ||||||||
| City: | SEATTLE | ||||||||
| State: | WA | ||||||||
| PostalCode: | 981258012 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2063638855 | ||||||||
| FaxNumber: | 2063679066 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/20/2005 | ||||||||
| LastUpdateDate: | 11/10/2011 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207W00000X | MD00033999 | WA | Y | Allopathic & Osteopathic Physicians | Ophthalmology |
ID Information
| ID | Type | State | Issuer | Description | 0133862 | 01 | WA | LABOR & INDUSTRIES | OTHER | 8196537 | 05 | WA | MEDICAID | 18003841 | 01 | RAILROAD MEDICARE | OTHER | HO3878 | 01 | REGENCE HEALTHCARE | OTHER |