Provider Demographics
NPI:1023351343
Name:EICHNER, JESSE DANIEL (MD)
Entity type:Individual
Prefix:DR
First Name:JESSE
Middle Name:DANIEL
Last Name:EICHNER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16806 E 20TH CT
Mailing Address - Street 2:
Mailing Address - City:VERADALE
Mailing Address - State:WA
Mailing Address - Zip Code:99037-9134
Mailing Address - Country:US
Mailing Address - Phone:425-530-0972
Mailing Address - Fax:
Practice Address - Street 1:800 W 5TH AVE FL 3
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99204-2803
Practice Address - Country:US
Practice Address - Phone:509-473-7672
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-04-04
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAML 60374825207L00000X
WAMD60741435207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology