Provider Demographics
NPI:1336250752
Name:WRIGHT, JONATHAN LAWRENCE (MD, MS)
Entity Type:Individual
Prefix:
First Name:JONATHAN
Middle Name:LAWRENCE
Last Name:WRIGHT
Suffix:
Gender:M
Credentials:MD, MS
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Other - First Name:
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Mailing Address - Street 1:1959 NE PACIFIC ST
Mailing Address - Street 2:BB1115, BOX 356510
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98195-6510
Mailing Address - Country:US
Mailing Address - Phone:206-543-3640
Mailing Address - Fax:206-543-3272
Practice Address - Street 1:1959 NE PACIFIC ST
Practice Address - Street 2:BOX 356510
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98195-0001
Practice Address - Country:US
Practice Address - Phone:206-543-3640
Practice Address - Fax:206-543-3272
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2013-04-29
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
WAML20007060208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology