Individual
MR. JASON LAMAR GATES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PMHNP-BC, MSN
Contact information
Practice address
2120 WASHINGTON BLVD, ARLINGTON, VA 22204-5718
(703) 228-5169
Mailing address
2626 WASHINGTON BLVD APT 1B, ARLINGTON, VA 22201-1441
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
0024186513
VA
Other
Enumeration date
09/14/2022
Last updated
08/07/2023
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