Jon Derik Mortensen PAC

  • NPI 1407930456
According to our database, the NPI number for Jon Derik Mortensen PAC is 1407930456 and activated since 17 years ago. Jon Derik Mortensen PAC is an individual provider who specializes in Medical, and the primary practice location is 10510 Gravelly Lake Dr., Lakewood, WA 98499. You can also contact Jon Derik Mortensen PAC via telephone number is (253) 589-7030. Provider NPI information was last updated on 06/14/2012.

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Overview of Jon Derik Mortensen PAC

  • NPI number: 1598434045
  • Provider type: Individual
  • Gender: Male
  • Active since: 10/25/2006
  • Last updated: 06/14/2012

Primary Scrop of Practice

  • Taxonomy Code: 363AM0700X
  • Specialty: Medical
  • License Number: PA10005073
  • License State: WA

Provider Mailing Address

  • Address: 1019 Pacific Ave Ste 300
    Attn Hr
    Tacoma, WA 98402
  • Phone: 253-722-1540
  • Fax:

Provider Practice Location

  • Address: 10510 Gravelly Lake Dr.
    Community Health Care - Lakewood Clinic
    Lakewood, WA 98499
  • Phone: 253-589-7030
  • Fax: 253-589-7033

Scope of Practice

  • Taxonomy Code: 363AM0700X
  • Specialty: Medical
  • License Number: PA10005073
  • License State: WA
  • Switch: Yes

Legacy Identifiers

  • Provider Identifier: 8469256
  • Identifier Type: Medicare Oscar/Certification
  • Identifier State: WA
  • Issuer:

Question & Answers

  • Q: What is the npi number?
  • A: An NPI is a 10-digit numeric identifier. It does not carry information about you, such as the State where you practice, your provider type, or your specialization. Your NPI will not change, even if your name, address, taxonomy, or other information changes.
  • Q: What are health care provider taxonomy codes?
  • A: The Health Care Provider (HCP) Taxonomy Codes Codes define a health care service provider type, classification, and area of specialization.
  • Q: What is the npi number for Jon Derik Mortensen PAC?
  • A: The npi number for Jon Derik Mortensen PAC is 1407930456.
  • Q: What are Jon Derik Mortensen PAC's specialties?
  • A: Jon Derik Mortensen PAC's specialties are Medical and different specialities.
  • Q: What is the medical license for Jon Derik Mortensen PAC?
  • A: The medical license number for Jon Derik Mortensen PAC is PA10005073 and issued in WA in USA.
  • Q: Where is Jon Derik Mortensen PAC practice location?
  • A: Jon Derik Mortensen PAC is practicing at 10510 Gravelly Lake Dr., Lakewood, WA 98499.
  • Q: How to contact Jon Derik Mortensen PAC?
  • A: You can contact Jon Derik Mortensen PAC via 253-589-7030.
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Content provided by MDNPI.com mainly comes from Centers for Medicare & Medicaid Services (CMS) published data and the FOIA-disclosable NPPES health care provider data file.