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General NPI Number Information
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NPI Number | 1770226813
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Entity Type | Individual
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Provider Name | JONATHON FOX
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Gender | Male
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Dates
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Enumeration Date | 04/17/2022
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Last Update Date | 12/08/2025
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Provider Practice Location Address
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Address Line | 336 CHARDONNAY AVE STE A
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City | PROSSER
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State | WA
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Zip | 99350-9515
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Country | US
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Telephone | 509-786-1576
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Fax |
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Provider Business Mailing Address
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Address Line | 1671 JERICHO RD
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City | RICHLAND
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State | WA
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Zip | 99352-8687
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Country | US
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Telephone | 813-323-0299
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Fax |
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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 | DO.OP.61688028
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License Number State | WA
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