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Individual

JAIME WASIK

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
RN, MSN, FNP

Contact information

Practice address
2850 SE POWELL VALLEY RD, GRESHAM, OR 97080-1494
(503) 666-5050
Mailing address
3873 GLENHAVEN WAY, KINGMAN, AZ 86409-4909
(928) 303-9287

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
202001769NP-PP
OR
363LF0000X
Family Nurse Practitioner
AP10563
AZ

Other

Enumeration date
09/06/2017
Last updated
04/14/2021
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