Provider Demographics
NPI:1174594881
Name:SIMMER, JOHN J (MD)
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:J
Last Name:SIMMER
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:7424 BRIDGEPORT WAY WEST.
Mailing Address - Street 2:SUITE 305
Mailing Address - City:LAKEWOOD
Mailing Address - State:WA
Mailing Address - Zip Code:98499-3402
Mailing Address - Country:US
Mailing Address - Phone:253-301-6960
Mailing Address - Fax:253-582-5938
Practice Address - Street 1:7424 BRIDGEPORT WAY WEST.
Practice Address - Street 2:SUITE 305
Practice Address - City:LAKEWOOD
Practice Address - State:WA
Practice Address - Zip Code:98499-3402
Practice Address - Country:US
Practice Address - Phone:253-301-6960
Practice Address - Fax:253-582-5938
Is Sole Proprietor?:No
Enumeration Date:2006-01-30
Last Update Date:2012-04-16
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Provider Licenses
StateLicense IDTaxonomies
MN34081207Y00000X
WA60167500207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology