Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Jack J Jorgenson, MD

Individual provider Family Medicine Physician · NPI 1922503168

Jack J Jorgenson, MD is a Family Practice in Shoreline, Washington. Graduated from Medical College of Wisconsin in 2018, 8 years ago. Practices with Ascension Medical Group-Southeast Wisconsin Inc, a 555-clinician group, accepts Medicare assignment and offers telehealth. Licensed in Washington.

Years since qualifying
8
Trained at
Medical College of Wisconsin
Licensed in
WA
In the registry since
2018
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

604 NW Richmond Beach Rd
Shoreline, WA 98177-3122
Phone: (206) 533-2900
Fax: (206) 533-2901
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X · Licence MD70005153 (WA)

Record details

NPI number1922503168
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedMarch 29, 2018
Last updated in NPPESFebruary 24, 2026
Certification dateFebruary 24, 2026
Mailing addressPo Box 25608, Salt Lake City, UT 84125-0608

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyFAMILY PRACTICE
Medical schoolMEDICAL COLLEGE OF WISCONSIN
Graduated 2018 (8 years in practice)
Group practice Ascension Medical Group-Southeast Wisconsin Inc — 555 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services
Practice locations4 on file with Medicare

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