Individual
DR. JASON R BOURNE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS, MS
Contact information
Practice address
815 STATE AVE, SUITE 3, MARYSVILLE, WA 98270-4254
(360) 659-0211
(360) 658-0716
Mailing address
815 STATE AVE, SUITE 3, MARYSVILLE, WA 98270-4254
(360) 659-0211
(360) 658-0716
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
DE00009603
WA
Other
Enumeration date
09/16/2006
Last updated
07/08/2007
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