Individual
JASON S GLADE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
NP
Contact information
Practice address
1268 LEE BOULEVARD, RICHLAND, WA 99352
(509) 942-2660
(509) 942-3836
Mailing address
560 GAGE BLVD SUITE 203, RICHLAND, WA 99352
(509) 942-3627
(509) 942-2268
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
309994-4405
UT
363L00000X
Nurse Practitioner
Primary
AP30007491
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0335446
LABOR & INDUSTRIES
WA
05
—
1083634620
—
WA
01
—
30999444000001
BCBS OF UTAH
UT
01
—
500030524
PALMETTO
—
Enumeration date
07/19/2006
Last updated
03/01/2021
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