Individual
MR. JARED MOETAO TONGAONEVAI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RN
Contact information
Practice address
1020 S MAIN ST, SLC, UT 84101-3176
(801) 539-7028
Mailing address
2085 E 9100 S, SANDY, UT 84093-2525
(801) 792-5358
Taxonomy
Speciality
Code
Description
License number
State
163WP0808X
Psychiatric/Mental Health Registered Nurse
Primary
5185700-3102
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
107031025101
INTERMTN HEALTH CARE
UT
Enumeration date
01/25/2006
Last updated
04/10/2008
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