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Individual

JASON E MARIS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PA

Contact information

Practice address
3950 MONTLAKE BLVD NE, ROOM 148, SEATTLE, WA 98195-0001
(206) 543-1552
(206) 543-6573
Mailing address
3950 MONTLAKE BLVD NE, ROOM 148, SEATTLE, WA 98195-0001
(206) 543-1552
(206) 543-6573

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA60310507
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1871699207
WA
Enumeration date
09/15/2006
Last updated
03/16/2013
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