Healthcare Provider Details

I. General information

NPI: 1619224508
Provider Name (Legal Business Name): JASON FREDERICK STUTZMAN FNP-BC, MSN, BSN
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/09/2012
Last Update Date: 04/24/2025
Certification Date: 04/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

220 OLYMPIC BLVD
EVERETT WA
98203-1918
US

IV. Provider business mailing address

8214 156TH ST SE
SNOHOMISH WA
98296-8728
US

V. Phone/Fax

Practice location:
  • Phone: 206-582-4601
  • Fax: 206-582-4698
Mailing address:
  • Phone: 559-321-6211
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License NumberAP60581583
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAP60581583
License Number StateWA
# 3
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number21511
License Number StateCA
# 4
Primary TaxonomyY
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License NumberAP60581583
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: