Provider Demographics
NPI:1548573769
Name:FREEMAN, JOHN ALEXANDER (MD, PHD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:ALEXANDER
Last Name:FREEMAN
Suffix:
Gender:M
Credentials:MD, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2779 SE CAMANO DR
Mailing Address - Street 2:
Mailing Address - City:CAMANO ISLAND
Mailing Address - State:WA
Mailing Address - Zip Code:98282-7020
Mailing Address - Country:US
Mailing Address - Phone:707-295-0911
Mailing Address - Fax:707-998-4573
Practice Address - Street 1:2779 SE CAMANO DR
Practice Address - Street 2:
Practice Address - City:CAMANO ISLAND
Practice Address - State:WA
Practice Address - Zip Code:98282-7020
Practice Address - Country:US
Practice Address - Phone:707-295-0911
Practice Address - Fax:707-998-4573
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-16
Last Update Date:2020-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD609583172084N0600X
CAC542412084P0800X
CAC 5421101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No2084N0600XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyClinical Neurophysiology
No2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry