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Individual

JEFFREY TYLER KASNICK

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
ARNP, FNP-BC

Contact information

Practice address
1217 COOPER POINT RD SW UNIT 2, OLYMPIA, WA 98502-7204
(360) 569-9690
Mailing address
14924 89TH AVE SE, YELM, WA 98597-8645
(360) 529-1791

Taxonomy

Speciality
Code
Description
License number
State
163WC0200X
Critical Care Medicine Registered Nurse
RN60678467
WA
363LF0000X
Family Nurse Practitioner
Primary
AP61455076
WA

Other

Enumeration date
02/10/2023
Last updated
06/23/2023
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