Provider Demographics
NPI:1164463378
Name:GRIGGS, JOSHUA D (MD)
Entity type:Individual
Prefix:DR
First Name:JOSHUA
Middle Name:D
Last Name:GRIGGS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1400 E. KINCAID STREET
Mailing Address - Street 2:SKAGIT REGIONAL CLINICS
Mailing Address - City:MOUNT VERNON
Mailing Address - State:WA
Mailing Address - Zip Code:98274-4127
Mailing Address - Country:US
Mailing Address - Phone:360-428-2501
Mailing Address - Fax:360-428-2596
Practice Address - Street 1:1400 E. KINCAID STREET
Practice Address - Street 2:STE A
Practice Address - City:MOUNT VERNON
Practice Address - State:WA
Practice Address - Zip Code:98274-4127
Practice Address - Country:US
Practice Address - Phone:360-428-2501
Practice Address - Fax:360-428-2596
Is Sole Proprietor?:No
Enumeration Date:2006-06-09
Last Update Date:2011-06-28
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MO2006015797207Q00000X
WAMD60219921207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MOP00345470OtherRAILROAD MEDICARE
MO201101805Medicaid
MOP00345470OtherRAILROAD MEDICARE
MOI59389Medicare UPIN