Individual
MR. JASON WILLIAM WHALEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
1024 S LEMAY AVE, FORT COLLINS, CO 80524-3929
(970) 495-7000
(303) 306-7753
Mailing address
PO BOX 912215, DENVER, CO 80291-2215
(303) 306-7783
(303) 306-7753
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
20331
CA
363A00000X
Physician Assistant
Primary
PA.0002245
CO
363AM0700X
Medical Physician Assistant
195
WY
363AM0700X
Medical Physician Assistant
2245
CO
363AM0700X
Medical Physician Assistant
506
AK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
46407871
—
CO
Enumeration date
03/19/2007
Last updated
02/19/2020
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