Provider Demographics
NPI:1952301277
Name:SACHS, JONATHAN R (MD)
Entity Type:Individual
Prefix:DR
First Name:JONATHAN
Middle Name:R
Last Name:SACHS
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 1:700 NE 87TH AVE
Mailing Address - Street 2:
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98664-1913
Mailing Address - Country:US
Mailing Address - Phone:360-397-3352
Mailing Address - Fax:360-604-1771
Practice Address - Street 1:501 SE 172ND AVE
Practice Address - Street 2:
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98684-9542
Practice Address - Country:US
Practice Address - Phone:360-882-2778
Practice Address - Fax:360-604-1712
Is Sole Proprietor?:No
Enumeration Date:2005-07-28
Last Update Date:2013-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA05287300207RG0100X
WAMD60347981207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
000795866OtherPERSONAL CHOICE
00795866OtherINDEPENDENCE BC
MES097OtherOXFORD
100011025OtherMEDICARE RR
0000606653OtherAMERIHEALTH PERSONAL CHOI
0453445OtherAETNA
042967000OtherAMERIHEALTH HMO
0821011000OtherKEYSTONE
10924169007OtherCIGNA
NJ2173905Medicaid
0453445OtherAETNA
NJ2173905Medicaid