Individual
DR. JONATHAN PETER LOPEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
4800 SAND POINT WAY NE, NEUROLOGY, MB.7.420, SEATTLE, WA 98105-3901
(206) 987-2078
(206) 987-2649
Mailing address
4800 SAND POINT WAY NE, NEUROLOGY, MB.7.420, SEATTLE, WA 98105-3901
(206) 987-2078
(206) 987-2649
Taxonomy
Speciality
Code
Description
License number
State
2084N0402X
Neurology with Special Qualifications in Child Neurology Physician
Primary
MD 60476381
WA
2084N0600X
Clinical Neurophysiology Physician
MD 60476381
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1622251
—
AK
01
—
G8933624
MEDICARE
—
01
—
G89336323
MEDICARE
—
Enumeration date
06/29/2007
Last updated
04/04/2016
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