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General NPI Number Information
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NPI Number | 1619380102
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Entity Type | Individual
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Provider Name | JARED R. BREESE PA-C
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Gender | Male
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Dates
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Enumeration Date | 06/03/2014
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Last Update Date | 09/30/2025
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Provider Practice Location Address
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Address Line | 14275 N 87TH ST
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City | SCOTTSDALE
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State | AZ
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Zip | 85260-3696
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Country | US
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Telephone | 480-905-8485
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Fax | 480-905-7274
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Provider Business Mailing Address
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Address Line | 5155 E. EAGLE DRIVE #20730
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City | MESA
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State | AZ
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Zip | 85277-3031
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Country | US
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Telephone | 480-706-9430
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Fax | 480-378-2273
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 5646
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License Number State | AZ
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