Individual
JONATHAN VINCENT WATT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3619 NE 174TH ST, VANCOUVER, WA 98686-1864
(360) 574-4163
Mailing address
3619 NE 174TH ST, VANCOUVER, WA 98686-1864
(360) 574-4163
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
MD00023791
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8415598
—
WA
Enumeration date
07/13/2006
Last updated
07/08/2007
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