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Individual

MR. JASON EDWARD VESTAL

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
ARNP

Contact information

Practice address
104 S FREYA ST STE GREEN210, SPOKANE, WA 99202-4862
(509) 368-9863
(509) 587-1575
Mailing address
104 S FREYA ST STE GREEN212, SPOKANE, WA 99202-4862
(509) 368-9863
(509) 587-1575

Taxonomy

Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
AP60814161
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1851899215
WA
Enumeration date
01/30/2018
Last updated
11/25/2025
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