Provider Demographics
NPI:1932300613
Name:JONES, WILLIAM BRADLEY (MD)
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:BRADLEY
Last Name:JONES
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19020 33RD AVE W
Mailing Address - Street 2:SUITE 210
Mailing Address - City:LYNNWOOD
Mailing Address - State:WA
Mailing Address - Zip Code:98036-4746
Mailing Address - Country:US
Mailing Address - Phone:425-563-1500
Mailing Address - Fax:425-563-1374
Practice Address - Street 1:19020 33RD AVE W
Practice Address - Street 2:SUITE 210
Practice Address - City:LYNNWOOD
Practice Address - State:WA
Practice Address - Zip Code:98036-4746
Practice Address - Country:US
Practice Address - Phone:425-563-1500
Practice Address - Fax:425-563-1374
Is Sole Proprietor?:No
Enumeration Date:2007-05-30
Last Update Date:2015-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD0002434252085N0700X
WAMD0004234252085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
No2085N0700XAllopathic & Osteopathic PhysiciansRadiologyNeuroradiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA324934OtherLNI PROVIDER ID
WA324936OtherLNI PROVIDER ID
WA8493884Medicaid
WA254069OtherLNI PROVIDER ID
WA8468993Medicaid
WA215374OtherLNI PROVIDER ID
WA324937OtherLNI PROVIDER ID
WAP00371916Medicare PIN
WAP00355439Medicare PIN
WA8862737Medicare PIN
WAP00867808Medicare PIN
WAG8919155Medicare PIN
WAG8884778Medicare PIN
WA8886042Medicare PIN
WA324937OtherLNI PROVIDER ID
WA324934OtherLNI PROVIDER ID
WAG8884777Medicare PIN
WA8862736Medicare PIN