Individual
JUDITH O SON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
404 BLACK HILLS LN SW STE D, OLYMPIA, WA 98502-8148
(360) 528-2100
(360) 528-2104
Mailing address
PO BOX 12389, OLYMPIA, WA 98508-2389
(360) 528-2100
(360) 528-2104
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
MD 00034244
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1025053
—
WA
01
—
107850
REGENCE
WA
01
—
110211856
RAILROAD MEDICARE
WA
01
—
136113
LABOR & INDUSTRIES
WA
Enumeration date
01/25/2007
Last updated
12/07/2012
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