Individual
JARED REX WORTHAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
1550 S PIONEER WAY, MOSES LAKE, WA 98837-4613
(509) 793-9787
(509) 764-3263
Mailing address
1616 S PIONEER WAY, MOSES LAKE, WA 98837-2487
(509) 793-9715
(509) 764-3244
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
O-0924
ID
208000000X
Pediatrics Physician
Primary
OP61442055
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2253195
—
WA
Enumeration date
04/30/2013
Last updated
05/04/2026
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