Individual
CARY JASPER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
A.N.P., N.D.
Contact information
Practice address
1006 KRESKY AVE STE 1, CENTRALIA, WA 98531-3723
(360) 264-2492
Mailing address
1006 KRESKY AVE STE 1, CENTRALIA, WA 98531-3723
(602) 642-4923
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
345
AK
363L00000X
Nurse Practitioner
Primary
AP60233048
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2069719
—
WA
05
—
NP1512
—
AK
Enumeration date
02/07/2007
Last updated
12/02/2024
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