# JOHN W ROSE

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1306859962
- **Gender:** Man
- **Credential:** ARNP CNM

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363L00000X | Nurse Practitioner | AP30003919 | WA | Yes |

## Other

- **Enumeration date:** 08/14/2006
- **Last updated:** 07/12/2012

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 9618257 | — | WA |
| 01 | — | G8896839 | MEDICARE | WA |