Kretzler, Jon Edward

Kretzler, Jon Edward is an individual health care provider with primary practice located at 625 9Th Ave Ste 210, Longview WA 98632-2465. He recently has only one registered license in Allopathic & Osteopathic Physicians / Orthopaedic Surgery, which is considered as his primary health care specialty. Kretzler, Jon Edward can be contacted via phone (360) 501-3400.

Contact Information

Primary practice address
625 9Th Ave Ste 210 Longview WA 98632-2465
Fax: (360) 423-6862
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Orthopaedic Surgery 207X00000X MD00030913 Washington

Profile Details

NPI number 1417922840
LBN Legal business name Kretzler, Jon Edward
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 20th, 2006
Last updated Jul 25th, 2007 - about 17 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1417922840 NPPES
Washington MEDICAID 1084128
Washington MEDICAID 057989

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