Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 363L00000X | Nurse Practitioner | ARNP9313499 | FL |
Y | 363LP0808X | Nurse Practitioner - Psychiatric/Mental Health | AP60684723 | WA |
NPI | 1023308954 |
---|---|
Provider Name | Scott A Jahner |
First Address | Tacoma, WA 98404-4922 |
Second Address | Tacoma, WA 98404-4922 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/04/2011 |
Last Update Date | 29/01/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
003562300 | (05) | FL |
1023308954 | (05) | WA |