Individual
DR. JEREMY SCOTT CARDINAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1304 FAWCETT AVE STE 100, TACOMA, WA 98402-1900
(253) 761-4200
(253) 761-4201
Mailing address
PO BOX 1535, TACOMA, WA 98401-1535
(253) 761-4200
(253) 383-3553
Taxonomy
Speciality
Code
Description
License number
State
2085N0700X
Neuroradiology Physician
MD167073
OR
2085N0700X
Neuroradiology Physician
MD60453057
WA
2085R0202X
Diagnostic Radiology Physician
MD167073
OR
2085R0202X
Diagnostic Radiology Physician
Primary
MD60453057
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0338843
L&I-TRA REST OF WA
WA
01
—
0338844
L&I-TRA KING COUNTY
WA
01
—
0338848
L&I-UNION AVE OPEN MRI
WA
01
—
0395156
L&I-DIAGNOSTIC IMAGING NW
WA
05
—
2036371
—
WA
05
—
500670649
—
OR
Enumeration date
06/03/2008
Last updated
08/29/2024
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