1. Home
  2. Directory
  3. Washington
  4. Seattle
  5. Student In An Organized Health Care Education Training Program
  6. NPI Profile

JEREMIAH WILLIS
NPI 1093688764
Student in an Organized Health Care Education/Training Program in Seattle, WA

Active since September 27, 2025
4311 11TH AVE NE STE 200, SEATTLE, WA 98105(206) 616-4001 Get Directions Write a Review

NPPES record last updated: September 27, 2025. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Jeremiah Willis NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

JEREMIAH WILLIS (NPI 1093688764) is an individual student in an organized health care education/training program in Seattle, Washington and active in the NPI registry since September 2025.

NPPES Registry Identity

NPI1093688764
Entity TypeIndividualMale
Primary Taxonomy390200000X
Provider Legal NameJEREMIAH WILLIS
Location Address4311 11TH AVE NE STE 200Seattle, WA 98105-6367
Mailing Address719 Sw 356th PlFederal Way, WA 98023-8133 · (253) 241-9390
Phone(206) 616-4001
Sole ProprietorNo
Enumeration DateSeptember 27, 2025
NPPES CertifiedSeptember 27, 2025
✔ NPI 1093688764 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care
Taxonomy Code390200000X
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
4311 11TH AVE NE STE 200, Seattle, WA 98105
Open in Google Maps ↗

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

ROGER SHERMAN PA-C
Physician Assistant (Medical)
4311 11TH AVE NE STE 200
SEATTLE, WA 98105
King County (216) 616-4001
DARCY LEIGH MULLIGAN
Physician Assistant
4311 11TH AVE NE STE 200
SEATTLE, WA 98105
King County (206) 616-4001
MERON H MILES
Physician Assistant (Surgical)
4311 11TH AVE NE STE 200
SEATTLE, WA 98105
King County (206) 616-4001
ANDREW SCOTT MISCOVICH PA-S
Student in an Organized Health Care Education/Training Program
4311 11TH AVE NE STE 200
SEATTLE, WA 98105
King County (206) 616-4001
LAURYN LOUISE CARR PA-C
Physician Assistant
4311 11TH AVE NE STE 200
SEATTLE, WA 98105
King County (206) 616-4001
MR. GABRIEL KRISTOPHER PUNAHELE IZUMI
Physician Assistant
4311 11TH AVE NE STE 200
SEATTLE, WA 98105
King County (206) 616-4001
JUNGSHENG SU
Physician Assistant
4311 11TH AVE NE STE 200
SEATTLE, WA 98105
King County (206) 616-4001
QUINSEY CHERI JORGENSON-DELACRUZ
Physician Assistant
4311 11TH AVE NE STE 200
SEATTLE, WA 98105
King County (206) 616-4001

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Jeremiah Willis's NPI number?

The NPI number for Jeremiah Willis is 1093688764. It was assigned to this individual provider in the NPPES registry on September 27, 2025.

Where is Jeremiah Willis located?

Jeremiah Willis practices at 4311 11th Ave NE Ste 200, Seattle, WA 98105. The listed phone number is (206) 616-4001.

What is Jeremiah Willis's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

When was this NPI record last updated?

The NPPES record for Jeremiah Willis was last updated on September 27, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.