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General NPI Number Information
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NPI Number | 1225135221
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Entity Type | Individual
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Provider Name | JONATHAN E.G. MCBRIDE MD
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Gender | Male
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Dates
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Enumeration Date | 09/20/2006
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Last Update Date | 04/17/2025
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Provider Practice Location Address
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Address Line | 3705 S MERIDIAN STE B
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City | PUYALLUP
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State | WA
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Zip | 98373-3709
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Country | US
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Telephone | 253-765-5050
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Fax | 415-252-7176
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Provider Business Mailing Address
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Address Line | 3705 S MERIDIAN STE B
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City | PUYALLUP
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State | WA
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Zip | 98373-3709
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Country | US
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Telephone | 253-765-5050
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Fax | 415-252-7176
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | MD26965
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License Number State | OR
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Taxonomy #2
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | MD00046768
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License Number State | WA
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Taxonomy #3
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | MD00046768
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License Number State | WA
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