Individual
DR. JONATHAN BERGH HALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3927 RUCKER AVE, EVERETT, WA 98201-4833
(425) 339-5422
(425) 339-5444
Mailing address
PO BOX 5127, EVERETT, WA 98206-5127
(425) 304-8431
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
MD00041279
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1184HA
BLUE SHIELD # VM
WA
05
—
8340978
—
WA
01
—
P00279718
RAILROAD MC # VM
WA
01
—
US5817026
AETNA PCP PIN VM
WA
Enumeration date
06/26/2006
Last updated
10/26/2023
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