Provider Demographics
NPI:1285060897
Name:BONN, JOSEPH JEFFREY (PA)
Entity type:Individual
Prefix:MR
First Name:JOSEPH
Middle Name:JEFFREY
Last Name:BONN
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Gender:M
Credentials:PA
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Mailing Address - Street 1:410 BIRCHWOOD AVE
Mailing Address - Street 2:SUITE 200
Mailing Address - City:BELLINGHAM
Mailing Address - State:WA
Mailing Address - Zip Code:98225
Mailing Address - Country:US
Mailing Address - Phone:360-734-9233
Mailing Address - Fax:360-738-8974
Practice Address - Street 1:410 BIRCHWOOD AVE
Practice Address - Street 2:SUITE 200
Practice Address - City:BELLINGHAM
Practice Address - State:WA
Practice Address - Zip Code:98225
Practice Address - Country:US
Practice Address - Phone:360-734-9233
Practice Address - Fax:360-738-8974
Is Sole Proprietor?:No
Enumeration Date:2013-09-16
Last Update Date:2016-11-23
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
G8950144Medicare UPIN