Individual
DR. JONATHAN EDWARD PUGMIRE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
633 JASON ST NE, SALEM, OR 97301-2750
(503) 581-8636
(503) 581-1237
Mailing address
633 JASON ST NE, SALEM, OR 97301-2750
(503) 581-8636
(503) 581-1237
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
MD60636844
WA
207VG0400X
Gynecology Physician
MD 23534
OR
207VX0000X
Obstetrics Physician
MD 23534
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
286501
—
OR
Enumeration date
06/08/2005
Last updated
01/19/2024
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