Individual
DR. JONATHAN MERLIN DAVISON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
MADIGAN ARMY MEDICAL CENTER 9040 JACKSON AVE, TACOMA, WA 98431-1000
(253) 968-1645
Mailing address
9040 JACKSON AVE MADIGAN ARMY MEDICAL CENTER, TACOMA, WA 98431-0001
(253) 968-1645
Taxonomy
Speciality
Code
Description
License number
State
207U00000X
Nuclear Medicine Physician
Primary
01055856A
IN
2085R0202X
Diagnostic Radiology Physician
01055856A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01055856A
PHYSICIAN LICENSE
IN
Enumeration date
05/01/2006
Last updated
03/14/2019
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