Individual
DR. JASON ERIC ROTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
910 W 5TH AVE, SUITE 1000, SPOKANE, WA 99204-2966
(509) 838-2531
(509) 755-6580
Mailing address
PO BOX 3649, SPOKANE, WA 99220-3649
(509) 838-2531
(509) 755-6580
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
034584
TN
207RC0000X
Cardiovascular Disease Physician
M10532
ID
207RC0000X
Cardiovascular Disease Physician
Primary
MD60015400
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
808313700
—
ID
05
—
8538670
—
WA
Enumeration date
04/08/2006
Last updated
08/02/2012
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