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Individual

JONATHAN K SONG

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.O.

Contact information

Practice address
1628 S MILDRED ST STE 102, TACOMA, WA 98465-1628
(206) 538-6300
(206) 538-6301
Mailing address
645 E MISSOURI AVE STE 300, PHOENIX, AZ 85012-1351
(602) 262-8917
(602) 262-8890

Taxonomy

Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
009208
AZ
2081P2900X
Pain Medicine (Physical Medicine & Rehabilitation) Physician
009208
AZ
2081P2900X
Pain Medicine (Physical Medicine & Rehabilitation) Physician
Primary
OP70102133
WA

Other

Enumeration date
04/12/2016
Last updated
06/01/2026
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