Provider Demographics
NPI:1629000484
Name:BARTOW, JOHN HARDING II (DO)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:HARDING
Last Name:BARTOW
Suffix:II
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 42
Mailing Address - Street 2:
Mailing Address - City:SILVERDALE
Mailing Address - State:WA
Mailing Address - Zip Code:98383-0042
Mailing Address - Country:US
Mailing Address - Phone:360-471-7713
Mailing Address - Fax:
Practice Address - Street 1:3417 ENSIGN RD NE
Practice Address - Street 2:
Practice Address - City:OLYMPIA
Practice Address - State:WA
Practice Address - Zip Code:98506-5064
Practice Address - Country:US
Practice Address - Phone:360-493-4609
Practice Address - Fax:360-493-4603
Is Sole Proprietor?:No
Enumeration Date:2006-07-06
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAOP00008962085B0100X, 2085N0904X, 2085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
No2085B0100XAllopathic & Osteopathic PhysiciansRadiologyBody Imaging
No2085N0904XAllopathic & Osteopathic PhysiciansRadiologyNuclear Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA168006OtherLABOR & INDUSTRIES
300138947OtherRAILROAD MEDICARE
WA8931358OtherCRIME VICTIMS COMP
WA1037811Medicaid
5389BAOtherREGENCE BLUESHIELD
4570345OtherAETNA
4570345OtherAETNA
300138947OtherRAILROAD MEDICARE
WAGAB36033Medicare PIN
WA168006OtherLABOR & INDUSTRIES
BB0931902OtherDEA
WAGAB36038Medicare PIN
WAGAB36035Medicare PIN
WAGAB36037Medicare PIN
WAGAB36034Medicare PIN