Individual
JASON NEILSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D,
Contact information
Practice address
624 E FRONT AVE, SPOKANE, WA 99202
(509) 626-9900
(509) 227-7070
Mailing address
PO BOX 421, LIBERTY LAKE, WA 99019-0421
(866) 747-2455
(509) 227-7070
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
9832794-1205
UT
Other
Enumeration date
06/05/2015
Last updated
07/12/2019
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