Provider Demographics
NPI:1770512881
Name:ALMQUIST, JON R (MD)
Entity type:Individual
Prefix:
First Name:JON
Middle Name:R
Last Name:ALMQUIST
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1100 9TH AVE
Mailing Address - Street 2:MS M4-PA
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98101-2756
Mailing Address - Country:US
Mailing Address - Phone:206-583-6025
Mailing Address - Fax:206-515-5886
Practice Address - Street 1:33501 1ST WAY S
Practice Address - Street 2:
Practice Address - City:FEDERAL WAY
Practice Address - State:WA
Practice Address - Zip Code:98003-6208
Practice Address - Country:US
Practice Address - Phone:253-838-2400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-01
Last Update Date:2008-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD000097852080A0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080A0000XAllopathic & Osteopathic PhysiciansPediatricsAdolescent Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAA325OtherBLUE SHIELD
WAP00047OtherPIERCE COUNTY
WAUS4119837OtherAETNA/USHC SPECIALIST
WAUS0899700OtherAETNA/USHC PCP
WA0039577OtherLABOR & INDUSTRY
WA1016005Medicaid
WAMD057WAOtherALASKA MEDICAID
WA000152929Medicare PIN
WA1016005Medicaid
WAP00047OtherPIERCE COUNTY