Provider Demographics
NPI:1235591058
Name:LAM KEENAN, JANNA
Entity type:Individual
Prefix:
First Name:JANNA
Middle Name:
Last Name:LAM KEENAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3906 BURKE AVE N
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98103-8343
Mailing Address - Country:US
Mailing Address - Phone:206-351-2020
Mailing Address - Fax:
Practice Address - Street 1:2475 140TH AVE NE BLDG C
Practice Address - Street 2:
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98005-1892
Practice Address - Country:US
Practice Address - Phone:425-828-2257
Practice Address - Fax:425-896-7034
Is Sole Proprietor?:No
Enumeration Date:2016-03-22
Last Update Date:2024-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD60929530208000000X, 208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics