Individual
MR. JASON ANTHONY BLANKENSHIP
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
2205 NE 129TH ST, VANCOUVER, WA 98686-3252
(360) 694-2544
(360) 694-1356
Mailing address
PO BOX 1506, CHEHALIS, WA 98532-2409
(360) 748-8632
(360) 748-3869
Taxonomy
Speciality
Code
Description
License number
State
163WC0200X
Critical Care Medicine Registered Nurse
200440093RN
OR
367500000X
Certified Registered Nurse Anesthetist
201160007CRNA
OR
367500000X
Certified Registered Nurse Anesthetist
63699
ID
367500000X
Certified Registered Nurse Anesthetist
Primary
AP60800275
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2016141
—
WA
05
—
500632648
—
OR
01
—
G8988518
MEDICARE WA
WA
01
—
G8988519
MEDICARE WA
WA
01
—
G8988520
MEDICARE WA
WA
01
—
G8988521
MEDICARE WA
WA
01
—
R206321
MEDICARE OR
OR
Enumeration date
05/24/2007
Last updated
11/18/2020
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