Individual
JEREMY A GINOZA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
4455 CORDATA PKWY, BELLINGHAM, WA 98226-8037
(360) 671-3225
Mailing address
1400 E. KINCAID STREET, ATTN: CREDENTIALING, MOUNT VERNON, WA 98274-4127
(360) 814-6724
Taxonomy
Speciality
Code
Description
License number
State
204D00000X
Neuromusculoskeletal Medicine & OMM Physician
OP60199411
WA
207Q00000X
Family Medicine Physician
Primary
OP60199411
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2030502
—
WA
Enumeration date
04/20/2009
Last updated
10/27/2021
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