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Individual

MR. JAMISON R RIDGELEY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1412 SW 43RD ST, SUITE 206, RENTON, WA 98057
(253) 236-5720
(425) 988-0168
Mailing address
1412 SW 43RD ST, SUITE 206, RENTON, WA 98057
(253) 236-5720
(425) 988-0168

Taxonomy

Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
MD60638738
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1174780530
NC
05
1184191603
WA
Enumeration date
05/21/2008
Last updated
11/24/2024
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