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General NPI Number Information
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NPI Number | 1467264770
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Entity Type | Individual
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Provider Name | JASON KINDLE
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Gender | Male
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Dates
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Enumeration Date | 01/23/2025
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Last Update Date | 01/23/2025
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Provider Practice Location Address
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Address Line | 322 S BIRCH ST
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City | MCCLEARY
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State | WA
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Zip | 98557-9522
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Country | US
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Telephone | 360-205-4750
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Fax |
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Provider Business Mailing Address
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Address Line | 923 STOCKWELL ST
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City | ABERDEEN
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State | WA
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Zip | 98520-8139
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Country | US
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Telephone | 360-580-9478
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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 | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | RN60288212
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License Number State | WA
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