Healthcare Provider Details

I. General information

NPI: 1366496697
Provider Name (Legal Business Name): JAMES P JEX M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/20/2006
Last Update Date: 07/25/2022
Certification Date: 07/25/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

118 S WHITCOMB AVE
TONASKET WA
98855-9287
US

IV. Provider business mailing address

118 N. WHITCOMB AVE C/O: CREDENTIALING
TONASKET WA
98855-2053
US

V. Phone/Fax

Practice location:
  • Phone: 509-486-3191
  • Fax: 509-486-4204
Mailing address:
  • Phone: 509-486-3191
  • Fax: 509-486-3176

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberMD61071879
License Number StateWA
# 2
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License NumberMD61071879
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: