Jon Derik Mortensen is a Medical in Tacoma, Washington. Jon Derik Mortensen practices all healthcare services and medical treatments related to Medical. The NPI Number for Jon Derik Mortensen is 1407930456. The last update date is 2012-06-14.
Jon Derik Mortensen's current location address is 1019 Pacific Ave Ste 300, Tacoma, Washington. You can contact this provider via phone number 2537221540. The mailing address for Jon Derik Mortensen is 1019 Pacific Ave Ste 300, Tacoma, Washington. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Jon Derik Mortensen |
|---|---|
| Address | 1019 Pacific Ave Ste 300, Tacoma, Washington |
| Phone Number | 2537221540 |
| Fax Number | |
| Sole Proprietor | N |
| Credentials | PAC |
NPI Number Detail
| NPI Number | 1407930456 |
|---|---|
| Provider Enumeration Date | 2006-10-25 |
| Last Updated Date | 2012-06-14 |
Provider Mailing Address Detail
| Address | 1019 Pacific Ave Ste 300 |
|---|---|
| City | Tacoma |
| State | Washington (WA) |
| Post Code | 984024488 |
| Phone Number | 2537221540 |
| Fax Number |
Provider's Primary Taxonomy Detail
| Speciality | Medical |
|---|---|
| Taxonomy | 363Am0700X |
| Licence No | PA10005073 |
|
Definition: A licensed healthcare professional who practices medicine under physician supervision focusing on medical diagnoses and treatment. |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 8469256 | WA | -- |
Post Comment/ Review Below
What is the unique identifier code issued to Jon Derik Mortensen by the Centers for Medicare & Medicaid Services (CMS)?
The Jon Derik Mortensen has been assigned the NPI (National Provider Identifier) 1407930456. This 10-digit code serves as a unique identification number for healthcare providers, issued by the CMS.
Could you share the physical location details of Jon Derik Mortensen?
The Jon Derik Mortensen is situated at 1019 Pacific Ave Ste 300, in the city of Tacoma, state of WA, with the zip code 984024488.
What is Jon Derik Mortensen's area of expertise and its corresponding taxonomy classification?
The Jon Derik Mortensen's field of specialization is Medical, and it falls under the taxonomy code 363Am0700X, which categorizes healthcare providers based on their areas of practice.
When did the Jon Derik Mortensen receive its 1407930456?
The Jon Derik Mortensen was issued its 1407930456 on 2006-10-25, which is the date when the organization was assigned this unique identifier.
As of what date was the information pertaining to Jon Derik Mortensen, such as address, specialty, and other details, last reviewed and confirmed to be accurate?
The information related to Jon Derik Mortensen, including its address, specialty, and other relevant details, was last reviewed and confirmed to be accurate on 2012-06-14.