Individual
DR. JIMMY DEAN CHUBBUCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2120 RYAN RD, BUCKLEY, WA 98321-9115
(360) 829-1111
Mailing address
2096 RYAN RD, BUCKLEY, WA 98321-9115
(360) 829-6304
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
20387
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1189107
—
WA
Enumeration date
04/10/2007
Last updated
11/27/2012
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