Provider Demographics
NPI:1558478255
Name:RETTMANN, JONATHAN ALLYN (MD)
Entity Type:Individual
Prefix:DR
First Name:JONATHAN
Middle Name:ALLYN
Last Name:RETTMANN
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:10180 SE SUNNYSIDE RD
Mailing Address - Street 2:PULMONOLOGY DEPARTMENT KAISER SUNNYSIDE MEDICAL OFFICE
Mailing Address - City:CLACKAMAS
Mailing Address - State:OR
Mailing Address - Zip Code:97015-9764
Mailing Address - Country:US
Mailing Address - Phone:503-813-3860
Mailing Address - Fax:503-571-9443
Practice Address - Street 1:10180 SE SUNNYSIDE RD
Practice Address - Street 2:PULMONOLOGY DEPARTMENT KAISER SUNNYSIDE MEDICAL OFFICE
Practice Address - City:CLACKAMAS
Practice Address - State:OR
Practice Address - Zip Code:97015-9764
Practice Address - Country:US
Practice Address - Phone:503-813-3860
Practice Address - Fax:503-571-9443
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-25
Last Update Date:2008-08-26
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
WAMD00043835207R00000X, 207RC0200X, 207RP1001X
ORMD21277207R00000X, 207RC0200X, 207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine