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Individual

DR. JOHN CHRISTOPHER EDWARDS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
3417 ENSIGN RD NE, OLYMPIA, WA 98506-5064
(360) 493-4600
(360) 493-4603
Mailing address
3417 ENSIGN RD NE, OLYMPIA, WA 98506-5064
(360) 493-4600
(360) 493-4603

Taxonomy

Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
MD00047431
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0378745
L&I-SOUTH SOUND RADIOLOGY
WA
01
0383902
L&I-RADIA REST OF WA
WA
05
1014770
WA
05
1619961570
WA
Enumeration date
09/07/2005
Last updated
01/30/2019
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