Individual
JASON MARK CLEVENSTINE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
3285 FERGUSON ST SW, TUMWATER, WA 98512-6143
(360) 943-1907
Mailing address
3285 FERGUSON ST SW, TUMWATER, WA 98512-6143
(360) 943-1907
Taxonomy
Speciality
Code
Description
License number
State
163WP0808X
Psychiatric/Mental Health Registered Nurse
Primary
RN60379269
WA
Other
Enumeration date
12/22/2025
Last updated
12/22/2025
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