Basic Information
| Provider Information | |||||||||
| NPI: | 1932141900 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | PAZEVIC | ||||||||
| FirstName: | JON-PIERRE | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | DO | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 34936 | ||||||||
| Address2: | DEPT 3028 | ||||||||
| City: | SEATTLE | ||||||||
| State: | WA | ||||||||
| PostalCode: | 981241936 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8883982473 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 21601 76TH AVE W | ||||||||
| Address2: | |||||||||
| City: | EDMONDS | ||||||||
| State: | WA | ||||||||
| PostalCode: | 980267507 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4256404100 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 06/12/2006 | ||||||||
| LastUpdateDate: | 05/27/2009 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207P00000X | 0P0001250 | WA | Y | Allopathic & Osteopathic Physicians | Emergency Medicine |
ID Information
| ID | Type | State | Issuer | Description | 910861251 | 01 | PREMERA BC | OTHER | 168565 | 01 | WA L & I | OTHER | E24152 | 01 | GROUP HEALTH | OTHER | PA0145 | 01 | REGENCE BS | OTHER | 8119174 | 05 | WA | MEDICAID | A003 | 01 | CHAMPUS | OTHER |