Individual
MR. CLARENCE JEP EDWARDS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ARNP
Contact information
Practice address
916 KOALA DR, OMAK, WA 98841-9759
(509) 663-8711
Mailing address
820 N CHELAN AVE, WENATCHEE, WA 98801-2028
(509) 663-8711
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
N31979
ID
363LF0000X
Family Nurse Practitioner
Primary
AP30006781
WA
363LF0000X
Family Nurse Practitioner
NP667A
ID
363LF0000X
Family Nurse Practitioner
NURRNLIC38969
MT
Other
Enumeration date
09/27/2005
Last updated
07/31/2019
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