Individual
DR. JONATHAN Y JIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
8511 S TACOMA WAY # 200, LAKEWOOD, WA 98499
(253) 588-4015
(253) 588-4035
Mailing address
8511 S TACOMA WAY # 200, LAKEWOOD, WA 98499-6521
(253) 588-4015
(253) 588-4035
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
MD00029836
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1077437
—
WA
01
—
912163079
TAX ID
—
Enumeration date
11/02/2005
Last updated
06/25/2018
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