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NPI Code Detail

MEDICARE: JONERIK ROSS

MEDICARE: JONERIK ROSS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1247200000XOther Technician

General Provider Information

NPI Number : 1578419016
Entity Type Code : Individual
Provider Name (Legal Business Name) : JONERIK ROSS
Provider Business Mailing Address
First Line : 907 HARNEY ST STE 100
Second Line :
City : VANCOUVER
State : WA
Zip : 98660-3038
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 907 HARNEY ST STE 100
Second Line :
City : VANCOUVER
State : WA
Zip : 98660-3038
Country : US
Telephone Number : 360-217-4205
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/06/2026
Last Update Date : 03/06/2026

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Directions to “ JONERIK ROSS ” Practice Location

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