Individual
JARED P WATERMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
2550 S PARKER RD, AURORA, CO 80014-1622
(303) 338-4545
Mailing address
10350 E DAKOTA AVE, DENVER, CO 80247-1314
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PAL-2929
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
23328
KAISER COMMERCIAL NUMBER
CO
05
—
88354318
—
CO
Enumeration date
08/06/2009
Last updated
06/02/2021
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