Individual
JASON S WAKAKUWA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
330 BROOKLINE AVE, DEPARTMENT OF ANESTHESIA, CRITICAL CARE AND PAIN MEDICI, BOSTON, MA 02215
(617) 667-3112
(617) 754-8791
Mailing address
330 BROOKLINE AVE, DEPARTMENT OF ANESTHESIA, CRITICAL CARE AND PAIN MEDICI, BOSTON, MA 02215
(617) 667-3112
(617) 754-8791
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
79935
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3138674
—
MA
Enumeration date
09/22/2005
Last updated
05/18/2022
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