Individual
JAKE YAMASAKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
3921 W BASELINE RD, LAVEEN, AZ 85339-1801
(602) 764-4037
Mailing address
12521 W LINCOLN ST, AVONDALE, AZ 85323-8454
(805) 448-3072
Taxonomy
Speciality
Code
Description
License number
State
163WS0200X
School Registered Nurse
Primary
270211
AZ
Other
Enumeration date
08/10/2022
Last updated
08/10/2022
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