Doctor Name: | DR. JASON ALEXANDER GRASSBAUGH |
NPI Number: | 1184697211 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | MD |
License Number: | 22965 |
Business Practice Address: | Madigan Army Medical Center Attn: Mchj-sop Tacoma, WA - 984310001 |
Business Phone Number: | 2539683121 |
Business Fax Number: | 2539681586 |
Mailing Address: | Mamc Dept Orthopedics, Bldg 9040a Fitzsimmons Ave TACOMA |
State: | WA |
Postal Code: | 984310001 |
Phone Number: | 9109683121 |
Fax Number: | |
NPI Enumeration Date: | 02/09/2006 |
NPI Last Update Date: | 04/17/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | 22965 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NE |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |