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Individual

JONATHAN ISAAC

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
700 NE 87TH AVE STE 210, VANCOUVER, WA 98664-1913
(360) 882-2778
(360) 604-1753
Mailing address
700 NE 87TH AVE, VANCOUVER, WA 98664-4896
(360) 882-2778

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
T-2558
MS
207RC0000X
Cardiovascular Disease Physician
Primary
MD60834235
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
T-2558
TEMPOPRARY STATE MEDICAL LICENSE
MS
Enumeration date
06/29/2012
Last updated
07/24/2018
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