Provider Demographics
NPI:1538120498
Name:ALLISON, JON C (MD)
Entity Type:Individual
Prefix:DR
First Name:JON
Middle Name:C
Last Name:ALLISON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:9040 REID ST
Mailing Address - Street 2:ATTN MCHJ-QCR
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98431-1100
Mailing Address - Country:US
Mailing Address - Phone:253-968-2252
Mailing Address - Fax:253-958-3278
Practice Address - Street 1:9040 REID ST
Practice Address - Street 2:ATTN MCHJ-QCR
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98431-1100
Practice Address - Country:US
Practice Address - Phone:253-968-2252
Practice Address - Fax:253-958-3278
Is Sole Proprietor?:No
Enumeration Date:2006-03-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD00033140207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine