MEDICARE: DR. JOSEPH F JASPER MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207LP2900X	Pain Medicine (Anesthesiology) Physician	0020206	WA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1134102551
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOSEPH F JASPER MD

Provider Business Mailing Address
First Line	:	PO BOX 65017
Second Line	:
City	:	UNIVERSITY PLACE
State	:	WA
Zip	:	98464-1017
Country	:	US
Telephone Number	:	253-686-9825
Fax Number	:

Provider Business Practice Location Address
First Line	:	2611 LEMONS BEACH RD W
Second Line	:
City	:	UNIVERSITY PLACE
State	:	WA
Zip	:	98466-1833
Country	:	US
Telephone Number	:	253-686-9825
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/21/2005
Last Update Date	:	10/14/2011

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