Provider Demographics
NPI:1255323754
Name:JANNEY, JAMES GARFIELD III (MD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:GARFIELD
Last Name:JANNEY
Suffix:III
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:212 SKYLINE DR
Mailing Address - Street 2:BOX 1519
Mailing Address - City:WHITE SALMON
Mailing Address - State:WA
Mailing Address - Zip Code:98672-8950
Mailing Address - Country:US
Mailing Address - Phone:509-493-2133
Mailing Address - Fax:
Practice Address - Street 1:212 SKYLINE DR
Practice Address - Street 2:
Practice Address - City:WHITE SALMON
Practice Address - State:WA
Practice Address - Zip Code:98672-8950
Practice Address - Country:US
Practice Address - Phone:509-493-2133
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-08-19
Last Update Date:2008-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD00013986207Q00000X
ORMD15177207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA8183600Medicaid
WAA08135Medicare UPIN
WA503835Medicare Oscar/Certification
WA8183600Medicaid
WA503836Medicare Oscar/Certification