Provider Demographics
NPI:1851387633
Name:BUTLER, JOHN (MD)
Entity Type:Individual
Prefix:MR
First Name:JOHN
Middle Name:
Last Name:BUTLER
Suffix:
Gender:M
Credentials:MD
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Other - Credentials:
Mailing Address - Street 1:939 MT VIEW DR
Mailing Address - Street 2:SUITE #100
Mailing Address - City:SHELTON
Mailing Address - State:WA
Mailing Address - Zip Code:98584-4410
Mailing Address - Country:US
Mailing Address - Phone:360-426-2653
Mailing Address - Fax:360-432-3586
Practice Address - Street 1:939 MT VIEW DR
Practice Address - Street 2:SUITE #100
Practice Address - City:SHELTON
Practice Address - State:WA
Practice Address - Zip Code:98584-4410
Practice Address - Country:US
Practice Address - Phone:360-426-2653
Practice Address - Fax:360-432-3586
Is Sole Proprietor?:No
Enumeration Date:2005-09-27
Last Update Date:2015-06-01
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
WAMD00015306207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine