Individual
JARED A BEVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
1055 N. CURTIS RD., BOISE, ID 83706-8370
(503) 372-2763
Mailing address
PO BOX 4268, PORTLAND, OR 97208-9720
(503) 372-2740
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
RN 9306861
FL
Other
Enumeration date
01/07/2013
Last updated
01/07/2013
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