Individual
DR. JEROME P MCDONNELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2731 77TH AVE SE STE 205, MERCER ISLAND, WA 98040-2800
(206) 232-5100
(206) 275-3716
Mailing address
2731 77TH AVE SE STE 205, MERCER ISLAND, WA 98040-2800
(206) 232-5100
(206) 275-3716
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
4466
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5011945
—
WA
Enumeration date
04/12/2007
Last updated
07/09/2007
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