Individual
JASON ALLEN RODGERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
2202 S CEDAR ST, STE 330, TACOMA, WA 98405-2318
(253) 272-5127
(253) 272-0811
Mailing address
2420 S UNION AVE, STE 200, TACOMA, WA 98405-1322
(253) 503-2598
(253) 404-0506
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
PA1124
NV
363A00000X
Physician Assistant
Primary
PAPA60207408
WA
363AM0700X
Medical Physician Assistant
PA60207408
WA
363AS0400X
Surgical Physician Assistant
PA60207408
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1568600492
—
NV
01
—
BN227Z
MEDICARE PTAN
NV
Enumeration date
01/30/2009
Last updated
09/26/2016
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