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General NPI Number Information
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NPI Number | 1194049510
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Entity Type | Organization
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Legal Business Name | JASON BERREMAN, ARNP, PS
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Dates
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Enumeration Date | 03/15/2010
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Last Update Date | 01/16/2023
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Provider Practice Location Address
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Address Line | 3810 KERN WAY SUITE D
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City | YAKIMA
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State | WA
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Zip | 98902-7805
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Country | US
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Telephone | 509-248-4303
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Fax | 509-469-2441
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Provider Business Mailing Address
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Address Line | 3810 KERN WAY SUITE D
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City | YAKIMA
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State | WA
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Zip | 98902-7805
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Country | US
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Telephone | 509-248-4303
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Fax | 509-469-2441
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Authorized Official
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Title or Position | PRESIDENT/ARNP
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Name | MR. JASON LEE BERREMAN
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Credential | ARNP
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Telephone | 509-248-4303
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM2500X
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Taxonomy Name | Medical Specialty Clinic/Center
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License Number | AP30006105
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License Number State | WA
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