John, Jerry
John, Jerry is an individual health care provider with primary practice located at 1901 S Cedar St Ste 101 , Tacoma WA 98405-2302. He recently has 3 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Advanced Heart Failure and Transplant Cardiology, Allopathic & Osteopathic Physicians / Internal Medicine, Allopathic & Osteopathic Physicians / Cardiovascular Disease. Allopathic & Osteopathic Physicians / Advanced Heart Failure and Transplant Cardiology is his primary health care specialty. John, Jerry can be contacted via phone (253) 301-5370.Contact Information
Primary practice address
1901 S Cedar St Ste 101
Tacoma WA 98405-2302
Phone: (253) 301-5370
Fax: (253) 301-5379
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Advanced Heart Failure and Transplant Cardiology | 207RA0001X | 0101274896 | Virginia |
| Allopathic & Osteopathic Physicians / Advanced Heart Failure and Transplant Cardiology | 207RA0001X | MD61593680 | Washington |
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | 200501438 | North Carolina |
| Allopathic & Osteopathic Physicians / Cardiovascular Disease | 207RC0000X | 5210479-1205 | Utah |
Profile Details
| NPI number | 1659440543 |
|---|---|
| LBN Legal business name | John, Jerry |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Nov 7th, 2006 |
| Last updated | Dec 24th, 2025 - about last year |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1659440543 | NPPES |
| Washington | MEDICAID | 2317636 | |
| Washington | Other | 140XV | |
| Washington | Other | 807070 | |
| Washington | Other | 183494 | |
| Washington | MEDICAID | 1659440543 | |
| Washington | MEDICAID | 5902155 |
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