Healthcare Provider Details

I. General information

NPI: 1790427391
Provider Name (Legal Business Name): JEREMY MICHAEL WRIGHT DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/13/2022
Last Update Date: 08/18/2025
Certification Date: 08/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

912 S SCHEUBER RD
CENTRALIA WA
98531
US

IV. Provider business mailing address

7919 VERONA LOOP SW
OLYMPIA WA
98512-5802
US

V. Phone/Fax

Practice location:
  • Phone: 360-736-2803
  • Fax:
Mailing address:
  • Phone: 352-345-7830
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberOP61608957
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: