Individual
JONATHAN B GREENE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
12100 SE STEVENS CT, SUITE 106, CLACKAMAS, OR 97086-4707
(503) 652-2880
Mailing address
301 S 320TH ST, FEDERAL WAY, WA 98003-5200
(253) 874-7000
(253) 874-7557
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
176706
OR
207W00000X
Ophthalmology Physician
4301100132
MI
207W00000X
Ophthalmology Physician
Primary
MD60714330
WA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
10/23/2008
Last updated
09/28/2022
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