Provider Demographics
NPI:1538303797
Name:KENDALL-WEED, JAMIE LAUREN (MD)
Entity type:Individual
Prefix:
First Name:JAMIE
Middle Name:LAUREN
Last Name:KENDALL-WEED
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:JAMIE
Other - Middle Name:LAUREN
Other - Last Name:BUSCH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:1401 6TH ST
Mailing Address - Street 2:
Mailing Address - City:BELLINGHAM
Mailing Address - State:WA
Mailing Address - Zip Code:98225-7057
Mailing Address - Country:US
Mailing Address - Phone:360-733-2904
Mailing Address - Fax:
Practice Address - Street 1:1310 10TH ST STE 104
Practice Address - Street 2:
Practice Address - City:BELLINGHAM
Practice Address - State:WA
Practice Address - Zip Code:98225-7026
Practice Address - Country:US
Practice Address - Phone:360-594-0592
Practice Address - Fax:360-526-2165
Is Sole Proprietor?:No
Enumeration Date:2009-04-30
Last Update Date:2022-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA116946207Q00000X
WAMD60749752207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA116946OtherMEDICAL BOARD OF CALIFORNIA