Provider Demographics
NPI:1902878580
Name:NEY, JOHN PETER (MD,)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:PETER
Last Name:NEY
Suffix:
Gender:M
Credentials:MD,
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:445 26TH AVE E
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98112-4728
Mailing Address - Country:US
Mailing Address - Phone:206-568-5490
Mailing Address - Fax:253-968-1440
Practice Address - Street 1:9040A FITZSIMMONS DR.
Practice Address - Street 2:
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98413
Practice Address - Country:US
Practice Address - Phone:206-968-0496
Practice Address - Fax:253-968-0443
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-02-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ININ 01056299A2084N0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0600XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyClinical Neurophysiology