Individual
JASON FERNANDEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CMA
Contact information
Practice address
4526 FEDERAL AVE # MS 11, EVERETT, WA 98203-2132
(425) 349-6200
Mailing address
17024 40TH AVE W, LYNNWOOD, WA 98037-7014
(206) 459-5659
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
CM60383237
WA
374700000X
Technician
Primary
60383237
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CM60383237
WADOH
WA
Enumeration date
03/21/2019
Last updated
08/19/2019
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