Individual
JONATHAN E DOMINGUEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
820 N CHELAN AVE, WENATCHEE, WA 98801-2028
(509) 663-8711
Mailing address
820 N CHELAN AVE, WENATCHEE, WA 98801-2028
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
MD00037649
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
132077
L&I
WA
05
—
1952332694
—
WA
01
—
315809
L&I POST 7/21/13
WA
01
—
P01256553
RR MEDICARE
WA
Enumeration date
07/05/2006
Last updated
06/15/2022
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