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Individual
JOHN ROBERT MATHESON
Active
Individual
JOHN ROBERT MATHESON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
MD00041012
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0184536
LIWA
WA
01
—
0204800
LIWA
WA
01
—
3075MA
BSWA
WA
01
—
4243MA
BSWA
WA
05
—
8314411
—
WA
Enumeration date
06/08/2006
Last updated
03/10/2008
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