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General NPI Number Information
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NPI Number | 1992395230
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Entity Type | Individual
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Provider Name | JANE E TAKEDA DNP, FNP-BC, BSN, RN
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Gender | Female
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Dates
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Enumeration Date | 01/21/2021
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Last Update Date | 01/06/2025
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Provider Practice Location Address
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Address Line | 7410 DELAWARE LN
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City | VANCOUVER
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State | WA
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Zip | 98664-1408
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Country | US
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Telephone | 360-566-4402
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Fax | 360-566-4406
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Provider Business Mailing Address
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Address Line | 7410 DELAWARE LN
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City | VANCOUVER
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State | WA
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Zip | 98664-1408
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Country | US
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Telephone | 360-566-4402
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Fax | 360-566-4406
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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 | RN61420190
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License Number State | WA
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Taxonomy #2
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Taxonomy Code | 163WM0705X
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Taxonomy Name | Medical-Surgical Registered Nurse
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License Number | 202009638
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License Number State | OR
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Taxonomy #3
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | AP61477773
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License Number State | WA
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