Individual
JAKE RYAN CHASTAIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
374 RAINBOW DR, SEDRO WOOLLEY, WA 98284-9587
(425) 327-3396
Mailing address
374 RAINBOW DR, SEDRO WOOLLEY, WA 98284-9587
(425) 327-3396
Taxonomy
Speciality
Code
Description
License number
State
146N00000X
Basic Emergency Medical Technician
Primary
ES. 60623189
WA
Other
Enumeration date
12/01/2016
Last updated
12/01/2016
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