Individual
JASON SCOTT GRAEME
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
1615 DELAWARE ST, LONGVIEW, WA 98632-2367
(360) 414-2700
(360) 414-2714
Mailing address
200 NE MOTHER JOSEPH PL, STE 210, VANCOUVER, WA 98664-3295
(360) 254-6161
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
PA60240564
WA
363AS0400X
Surgical Physician Assistant
Primary
PA60240564
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0285594
LABOR & INDUSTRIES
WA
05
—
2015043
—
WA
05
—
500640668
—
OR
Enumeration date
02/09/2007
Last updated
07/14/2021
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