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

Jeremiah Willis

Individual provider Student in an Organized Health Care Education/Training Program · NPI 1093688764

Jeremiah Willis is a Student in an Organized Health Care Education/Training Program in Seattle, Washington. Licensed in Washington. Registered with an NPI since 2025.

Licensed in
WA
In the registry since
2025

Practice location Address checks out

4311 11th Ave NE Ste 200
Seattle, WA 98105-6367
Phone: (206) 616-4001
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Student in an Organized Health Care Education/Training Program (primary) Taxonomy 390200000X (WA)

Record details

NPI number1093688764
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedSeptember 27, 2025
Last updated in NPPESSeptember 27, 2025
Certification dateSeptember 27, 2025
Mailing address719 Sw 356th Pl, Federal Way, WA 98023-8133

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