Grant, Jonathan R
Grant, Jonathan R is an individual health care provider with primary practice located at 111 S 13Th St , Mount Vernon WA 98274-4105. He recently has 5 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Otolaryngology, Allopathic & Osteopathic Physicians / Otolaryngology/Facial Plastic Surgery, Allopathic & Osteopathic Physicians / Plastic Surgery Within the Head and Neck, Allopathic & Osteopathic Physicians / Surgery, Allopathic & Osteopathic Physicians / Plastic and Reconstructive Surgery. Allopathic & Osteopathic Physicians / Otolaryngology/Facial Plastic Surgery is his primary health care specialty. Grant, Jonathan R can be contacted via phone (360) 336-2178.Contact Information
Primary practice address
111 S 13Th St
Mount Vernon WA 98274-4105
Phone: (360) 336-2178
Fax: (360) 336-1674
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Otolaryngology | 207Y00000X | 47898-020 | Wisconsin |
| Allopathic & Osteopathic Physicians / Otolaryngology | 207Y00000X | 242010 | Massachusetts |
| Allopathic & Osteopathic Physicians / Otolaryngology/Facial Plastic Surgery | 207YX0905X | MD60187241 | Washington |
| Allopathic & Osteopathic Physicians / Plastic Surgery Within the Head and Neck | 2082S0099X | MD60187241 | Washington |
| Allopathic & Osteopathic Physicians / Surgery | 208600000X | MD60187241 | Washington |
| Allopathic & Osteopathic Physicians / Plastic and Reconstructive Surgery | 2086S0122X | MD60187241 | Washington |
Profile Details
| NPI number | 1912064577 |
|---|---|
| LBN Legal business name | Grant, Jonathan R |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jan 2nd, 2007 |
| Last updated | Mar 15th, 2012 - about 12 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1912064577 | NPPES |
| Washington | Other | 0271141 | LABOR AND INDUSTRIES |
| Washington | MEDICAID | 2009841 | LABOR AND INDUSTRIES |
| Washington | Other | P00700778 | LABOR AND INDUSTRIES |
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