Individual
DR. JONATHAN DAVID DEBOOY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
101 W IRONWOOD DR STE 250, COEUR D ALENE, ID 83814-1415
(208) 765-8585
(425) 407-1112
Mailing address
PO BOX 35145 #40023, SEATTLE, WA 98124-5145
(425) 407-1500
(425) 407-1112
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
A107920
CA
207L00000X
Anesthesiology Physician
Primary
M-13851
ID
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
06/10/2008
Last updated
12/18/2019
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