Healthcare Provider Details

I. General information

NPI: 1598842635
Provider Name (Legal Business Name): JEAN C LASKEY RN, LMP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/01/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

231 W PATISON ST
PORT HADLOCK WA
98339-9751
US

IV. Provider business mailing address

252 PROTECTION RIDGE DR
PORT TOWNSEND WA
98368-9680
US

V. Phone/Fax

Practice location:
  • Phone: 360-531-3178
  • Fax: 360-385-3798
Mailing address:
  • Phone: 360-531-3178
  • Fax: 360-385-3798

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN00065485
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code225700000X
TaxonomyMassage Therapist
License NumberMA00012783
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: