Irving, Jacob R

Irving, Jacob R is an individual health care provider with primary practice located at 810 Jasmine St , Omak WA 98841-9578. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered, which is considered as his primary health care specialty. Irving, Jacob R can be contacted via phone (509) 826-1760.

Contact Information

Primary practice address
810 Jasmine St Omak WA 98841-9578
Phone: (509) 826-1760
Fax: (509) 826-7211
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered 367500000X AP60190539 Washington
Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered 367500000X RN60190693 Washington

Profile Details

NPI number 1376873844
LBN Legal business name Irving, Jacob R
Credentials Certified Registered Nurse Anesthetist (CRNA)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 6th, 2010
Last updated Jun 10th, 2013 - about 12 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1376873844 NPPES
Washington Other 0247069 L&I

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