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General NPI Number Information
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NPI Number | 1427198852
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Entity Type | Individual
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Provider Name | CARY JASPER A.N.P., N.D.
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Gender | Male
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Dates
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Enumeration Date | 02/07/2007
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Last Update Date | 12/02/2024
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Provider Practice Location Address
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Address Line | 1006 KRESKY AVE STE 1
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City | CENTRALIA
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State | WA
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Zip | 98531-3723
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Country | US
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Telephone | 360-264-2492
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Fax |
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Provider Business Mailing Address
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Address Line | 1006 KRESKY AVE STE 1
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City | CENTRALIA
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State | WA
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Zip | 98531-3723
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Country | US
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Telephone | 602-642-4923
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 345
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License Number State | AK
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Taxonomy #2
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | AP60233048
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License Number State | WA
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