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Individual

JASON LOREN WHITNEY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
ARNP FNP-C

Contact information

Practice address
13051 US HWY 12, STE 2, PACKWOOD, WA 98361
(360) 496-3777
Mailing address
1615 DELAWARE ST, LONGVIEW, WA 98632-2367
(360) 414-2385

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
AP61034006
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
AP61034006
WA
Enumeration date
01/08/2020
Last updated
02/02/2024
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