Individual
JAMES GREEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
1322 3RD ST SE, SUITE 240, PUYALLUP, WA 98372
(253) 697-1420
(253) 697-1439
Mailing address
2493 S WILDCAT WAY UNIT B, WOODS CROSS, UT 84010-8292
(801) 693-3020
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
10748354-1204
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3007238
—
UT
Enumeration date
04/08/2015
Last updated
08/03/2018
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