Provider Demographics
NPI:1518326529
Name:MACDONALD, JOHN CAMERON III (PA-C)
Entity type:Individual
Prefix:MR
First Name:JOHN
Middle Name:CAMERON
Last Name:MACDONALD
Suffix:III
Gender:M
Credentials:PA-C
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Mailing Address - Street 1:PO BOX 25608
Mailing Address - Street 2:
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84125-0608
Mailing Address - Country:US
Mailing Address - Phone:206-320-4476
Mailing Address - Fax:206-568-7043
Practice Address - Street 1:601 BROADWAY
Practice Address - Street 2:STE 600
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98122-5330
Practice Address - Country:US
Practice Address - Phone:206-386-6171
Practice Address - Fax:206-860-6634
Is Sole Proprietor?:No
Enumeration Date:2016-02-18
Last Update Date:2024-12-23
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Provider Licenses
StateLicense IDTaxonomies
WAPA60633781363AS0400X, 363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical