Individual
JESSE I BROOME
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
1615 DELAWARE ST, LONGVIEW, WA 98632-2367
(360) 414-2000
Mailing address
PO BOX 5157, VANCOUVER, WA 98668-5157
(360) 828-5396
(360) 828-5455
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
9310702
FL
367500000X
Certified Registered Nurse Anesthetist
Primary
AP60556936
WA
Other
Enumeration date
02/28/2013
Last updated
05/18/2023
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