Individual
JONATHAN LEE CUSTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
9040 JACKSON AVE, TACOMA, WA 98431-4504
(253) 968-0198
Mailing address
3621 STORM RDG, SCHERTZ, TX 78108-2030
(901) 335-5650
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
RN293835
GA
Other
Enumeration date
06/30/2020
Last updated
04/25/2023
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